TY - JOUR
T1 - Management of conjunctival melanoma with local excision and adjuvant brachytherapy
AU - Brouwer, Niels J.
AU - Marinkovic, Marina
AU - Peters, Femke P.
AU - Hulshof, Maarten C. C. M.
AU - Pieters, Bradley R.
AU - de Keizer, Rob J. W.
AU - Horeweg, Nanda
AU - Laman, Mirjam S.
AU - Bleeker, Jaco C.
AU - van Duinen, Sjoerd G.
AU - Jager, Martine J.
AU - Creutzberg, Carien L.
AU - Luyten, Gregorius P. M.
N1 - Funding Information: Funding NJB is the recipient of a MD/PhD-programme grant of the Leiden University Medical Center. The sponsor or funding organisation had no role in the design or conduct of this research. Publisher Copyright: © 2020, The Author(s), under exclusive licence to The Royal College of Ophthalmologists.
PY - 2021/2
Y1 - 2021/2
N2 - Background/objectives: To evaluate the management of conjunctival melanoma with local excision and adjuvant brachytherapy. Subjects/methods: Data of all patients who received local excision and adjuvant brachytherapy for conjunctival melanoma between 1999 and 2016 in a Dutch national referral centre were reviewed. A protocol with Sr-90 was used until 2012, a protocol with Ru-106 was used hereafter. Local recurrence, metastasis, survival, visual acuity and treatment complications were assessed. Results: A total of 58 patients was identified: 32 patients were treated with Sr-90 and 26 with Ru-106. Mean follow-up time was 97.3 months (143.1 months after Sr-90, and 40.2 months after Ru-106). All lesions were epibulbar, the median tumour thickness was 0.9 mm. Local recurrence occurred in 13/58 cases (22%), with a 5-year recurrence rate of 21%. Local recurrence occurred equally often in both protocols, with 5-year recurrence rates of 19% (Sr-90) versus 23% (Ru-106) (p = 0.68). Metastasis developed in 3/58 cases (5%), with 2 cases after Sr-90, and 1 after Ru-106 (p = 1.00). The most reported complications were pain (29%), dry eyes (21%), symblepharon (9%), ptosis (12%) and cataract (9%). No severe corneal or scleral complications were observed. Median visual acuity was 1.00 pre-surgery, at the end of follow-up this was 1.00 (Sr-90) and 0.95 (Ru-106). Conclusion: Local excision with adjuvant brachytherapy provides good tumour control with excellent visual outcome and mild side effects in patients with limited conjunctival melanoma. Results after Sr-90 or Ru-106 were comparable; a choice for either treatment may be based on experience of the clinician and availability of materials.
AB - Background/objectives: To evaluate the management of conjunctival melanoma with local excision and adjuvant brachytherapy. Subjects/methods: Data of all patients who received local excision and adjuvant brachytherapy for conjunctival melanoma between 1999 and 2016 in a Dutch national referral centre were reviewed. A protocol with Sr-90 was used until 2012, a protocol with Ru-106 was used hereafter. Local recurrence, metastasis, survival, visual acuity and treatment complications were assessed. Results: A total of 58 patients was identified: 32 patients were treated with Sr-90 and 26 with Ru-106. Mean follow-up time was 97.3 months (143.1 months after Sr-90, and 40.2 months after Ru-106). All lesions were epibulbar, the median tumour thickness was 0.9 mm. Local recurrence occurred in 13/58 cases (22%), with a 5-year recurrence rate of 21%. Local recurrence occurred equally often in both protocols, with 5-year recurrence rates of 19% (Sr-90) versus 23% (Ru-106) (p = 0.68). Metastasis developed in 3/58 cases (5%), with 2 cases after Sr-90, and 1 after Ru-106 (p = 1.00). The most reported complications were pain (29%), dry eyes (21%), symblepharon (9%), ptosis (12%) and cataract (9%). No severe corneal or scleral complications were observed. Median visual acuity was 1.00 pre-surgery, at the end of follow-up this was 1.00 (Sr-90) and 0.95 (Ru-106). Conclusion: Local excision with adjuvant brachytherapy provides good tumour control with excellent visual outcome and mild side effects in patients with limited conjunctival melanoma. Results after Sr-90 or Ru-106 were comparable; a choice for either treatment may be based on experience of the clinician and availability of materials.
UR - http://www.scopus.com/inward/record.url?scp=85084129508&partnerID=8YFLogxK
U2 - https://doi.org/10.1038/s41433-020-0879-z
DO - https://doi.org/10.1038/s41433-020-0879-z
M3 - Article
C2 - 32332870
SN - 0950-222X
VL - 35
SP - 490
EP - 498
JO - Eye (London, England)
JF - Eye (London, England)
IS - 2
ER -