Introduction
The aim of this study was to evaluate the efficacy and vision-threatening complications of brachytherapy with ruthenium-106 (106Ru) plaque to treat uveal melanoma.

Material and methods
A literature review was performed based on results from searching PubMed, Embase, Web of Science, Scopus, and Cochrane databases, using the following key words: “choroidal melanoma”, “uveal melanoma”, “brachytherapy”, and “ruthenium-106”. We included studies performed on more than 30 patients since 1986, reporting on local control rate, complications rate, mean radiation dose, and mean tumor thickness. The cumulative analysis was performed using Metaprop command of Stata v.16, and meta-regression was conducted based on mean tumor thickness and mean radiation dose to tumor’s apex.

Results
Twenty-one retrospective studies were selected, involving 3,913 patients treated primarily with 106Ru plaque brachytherapy. The range of radiation dose to tumor apex was from 70 Gy to 250 Gy. The local control rate following brachytherapy ranged from 59% to 98%, and the overall weighted mean of local control was 84%. However, the heterogeneity between studies’ reports was remarkable (I2 = 95.40%). Meta-regression based on tumor thickness and mean dose of radiation to the apex showed that the studies’ heterogeneity was minimally related to the difference in mean tumor size (I2 = 92%). The correlation between larger tumor size and lower local control rate was statistically significant (p-value = 0.024). There was no significant correlation between the mean radiation dose and local control rate (p-value = 0.679). The most commonly reported complications were cataract and radiation-related retinopathy.

Conclusions
Although the studies’ heterogeneity was high, in a prescription dose ranging from 70 Gy to 250 Gy to the tumor apex, 106Ru brachytherapy seems to be successful in local control of uveal melanoma. The efficacy of 106Ru in controlling uveal melanomas decreased with the increase in tumor thickness. However, these outcomes should be verified in randomized comparative studies.



中文翻译：

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钌 106 近距离放射治疗葡萄膜黑色素瘤的疗效和并发症：系统评价和荟萃分析

简介
本研究的目的是评估钌 106 (106Ru) 斑块近距离放射治疗葡萄膜黑色素瘤的疗效和威胁视力的并发症。

材料和方法
根据搜索 PubMed、Embase、Web of Science、Scopus 和 Cochrane 数据库的结果进行文献回顾，使用以下关键词：“脉络膜黑色素瘤”、“葡萄膜黑色素瘤”、“近距离放射治疗”和“钌” -106”。我们纳入了自 1986 年以来对 30 多名患者进行的研究，报告了局部控制率、并发症发生率、平均辐射剂量和平均肿瘤厚度。使用 Stata v.16 的 Metaprop 命令进行累积分析，并根据平均肿瘤厚度和肿瘤顶点的平均辐射剂量进行元回归。

结果
选择了 21 项回顾性研究，涉及 3,913 名主要接受 106Ru 斑块近距离放射治疗的患者。对肿瘤顶点的辐射剂量范围为70 Gy至250 Gy。近距离放射治疗后的局部控制率从 59% 到 98% 不等，局部控制的总体加权平均值为 84%。然而，研究报告之间的异质性显着（I2 = 95.40%）。基于肿瘤厚度和顶点平均辐射剂量的 Meta 回归表明，研究的异质性与平均肿瘤大小的差异（I2 = 92%）的相关性很小。较大的肿瘤大小和较低的局部控制率之间的相关性具有统计学意义（p 值 = 0.024）。平均辐射剂量与局部控制率之间没有显着相关性（p 值 = 0.679）。

结论
虽然研究的异质性很高，但在 70 Gy 到 250 Gy 到肿瘤顶点的处方剂量范围内，106Ru 近距离放射治疗似乎成功地局部控制了葡萄膜黑色素瘤。106Ru对葡萄膜黑色素瘤的控制效果随着肿瘤厚度的增加而降低。然而，这些结果应在随机比较研究中得到验证。