Purpose

To examine the efficacy and safety of ruthenium-106 (106Ru) ocular surface brachytherapy for incompletely excised conjunctival melanoma (CM) and conjunctival squamous cell carcinoma (CSCC) patients, with no adjunctive treatments applied to the primary tumor beds treated with 106Ru brachytherapy.

Material and methods

A retrospective analysis of a consecutive cohort of eight patients (four with CM and four with CSCC), treated at the Department of Ophthalmology of the University Hospital of Heraklion, was performed. All patients underwent adjuvant 106Ru plaque brachytherapy using a CCB (BEBIG) plaque, delivering 100 Gy at a depth of 1 mm.

Results

An overall local tumor control rate of 75% was observed during a follow-up period of 18-75 months. In two patients (one CM and one CSCC), orbital exenteration was required due to orbital invasion. Both cases involved neglected and extensive lesions, suggesting possible pre-existing microscopic deeper infiltration. No radiation-related ocular surface toxicity was observed.

Conclusions

In line with previous reports, these findings highlight the role of ocular surface brachytherapy in the management of incompletely excised conjunctival malignancies. Ruthenium-106 surface brachytherapy may represent an effective sole adjunctive treatment option for selected cases of CM and CSCC, even when using plaques designed for intra-ocular applications, such as CCB (BEBIG) plaque.