Abstract ID: 26-110
Small choroidal melanoma recurrence after plaque radiotherapy: influence of scleral dose and tumour characteristics
Author: Pragya Saini Base Hospital / Institution: Moorfields Eye Hospital NHS trust
Presentation Type: ePoster Presentation
Purpose
The optimal management of small choroidal melanoma remains debated, particularly early intervention versus observation. Factors associated with local recurrence in small tumours following plaque brachytherapy are not well characterised. This study evaluated local tumour control and examined demographic, tumour related and treatment related predictors of local recurrence following plaque brachytherapy for small choroidal melanoma.
Methods
We conducted a retrospective single centre study of 183 consecutive patients with small choroidal melanoma treated with ruthenium plaque brachytherapy between January2015 and December2023. Demographics (age, sex, ethnicity), tumour characteristics (thickness, basal diameter, plaque size), scleral radiation dose, and the interval between primary and secondary procedures were analysed. Local recurrence was stratified by scleral dose (100–199Gy vs ≥200Gy), and subsequent management (repeat plaque, proton beam radiotherapy, enucleation) was documented.
Results
Sixteen of 183 tumours(8.7%) developed local recurrence. Recurrence rates were 6.2%(7/113) in the 100–199Gy group and 12.9% (9/70) in the ≥200Gy group(p=0.177). Neither tumour thickness (p=0.996) nor basal diameter(p=0.752) predicted recurrence. Patients aged 51–80years accounted for 12/16(75%) recurrences. Notched 20mm plaques were used in 11/16 (68.8%) recurrences. Secondary interventions differed significantly between dose groups (p=0.036): enucleation was required in 7/9(77.8%) recurrences after ≥200Gy compared with 1/7(14.3%) after 100–199Gy. Two eyes received very high scleral doses(>350Gy), and neither developed local recurrence. Median time from primary to secondary intervention was 28.5months.
Conclusion
Local recurrence after plaque brachytherapy for small choroidal melanoma is uncommon. Scleral dose ≥200Gy did not reduce recurrence and was associated with higher enucleation rates, suggesting that it may not improve local tumour control.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Alice | Carlin | St Bartholomew’s Hospital |
| Beatrice | Gallo | Moorfields Eye Hospital NHS trust |
| Bertil | Damato | Moorfields Eye Hospital NHS trust |
| Amit | Arora | Moorfields Eye Hospital NHS trust |
| Mandeep | S. Sagoo | Moorfields Eye Hospital NHS trust |