Description:
<jats:title>Abstract</jats:title><jats:sec><jats:title>Purpose</jats:title><jats:p>To evaluate the treatment of selected patients with uveal melanoma with endoresection and adjuvant ruthenium brachytherapy.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Thirty‐five patients with uveal melanoma not suitable for ruthenium plaque monotherapy were treated with endoresection and adjuvant ruthenium brachytherapy between January 2001 and October 2013. Recurrence‐free survival, globe retention, course of visual acuity (<jats:styled-content style="fixed-case">VA</jats:styled-content>), occurrence of therapy‐related complications and metastasis‐free and overall survival were analysed retrospectively.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Eight patients (22.9%) had a tumour recurrence after a median follow‐up of 49.5 months (range: 21–134 months). Enucleation was necessary in eight patients. Thirty‐two patients (91%) had a loss of <jats:styled-content style="fixed-case">VA</jats:styled-content> with a median loss of nine lines (range: 0 to −39 lines); <jats:styled-content style="fixed-case">VA</jats:styled-content> was stable in three patients and no patients had a gain in <jats:styled-content style="fixed-case">VA</jats:styled-content>. Four patients (11.4%) developed radiation retinopathy. Metastases were detected in seven patients (20.0%) during follow‐up. The occurrence of metastasis was significantly associated with monosomy 3 (p < 0.0001). Twenty‐four patients (68.6%) were alive at the end of follow‐up. Five patients (14.3%) died because of uveal melanoma (UM) metastasis.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Endoresection with adjuvant ruthenium brachytherapy is an option for selected patients with <jats:styled-content style="fixed-case">UM</jats:styled-content> who cannot be treated with brachytherapy as monotherapy. About two‐thirds of eyes can be retained long term without recurrences. Visual acuity cannot be maintained in most cases, and may even decrease considerably. Radiation complications are comparatively rare and not a significant problem.</jats:p></jats:sec>