A Comparative Study of the Efficacy of Transpupillary Thermotherapy and Brachytherapy in the Treatment of Residual Choroidal Melanomas
Treatment efficacy of transpupillar thermotherapy (TTT) and brachytherapy (BT) of residual choroidal melanomas (CM) were compared for two groups of patients with small residual CMs after BT. The first group (39 patients) underwent TTT, the second group (30 patients, archive) had a repeated BT. As shown by a 3-year follow-up, a positive result was achieved in 84.7% of patients who received TTT and in 90% of patients after the repeated BT, which is not statistically significant (p>0.05). Complete tumor resorption could be achieved in many more subjects of the first group (56.4%) than in the second group (36.6%) (р<0.05). The repeated BT were followed more frequently (p<0.05) by complications, which were irreversible and resulted in a more noticeable reduction of visual acuity. In contrast, complications after TTT were transitory. Weakly pigmented, hypervascular tumors and tumors located at the extreme periphery of eye fundus were found to be less amenable to laser treatment. It could thus be ascertained that TTT is the method of choice for the treatment of residual CMs with the prominence of 3.5 mm or more, located centrally or at medium periphery of the eye fundus. The method expands the possibilities of eye-preserving treatment with minimal complications and the maximally possible retention of visual functions.