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Impressum
Transpupillary thermotherapy (TTT) of malignant choroidal melanoma as single therapy or adjuvant to brachytherapy with ruthenium plaque: indications, options and limitations of TTT
Vij O., Bornfeld N.
University Eye Hospital, Hufelandstr. 55, 45122 Essen, Germany
Introduction: For therapy of malignant choroidal melanoma several
new therapeutic conceps have been established in recent years. Single
transpupillary thermotherapy (TTT) or adjuvant TTT in combination with
brachytherapy is considered frequently because of its simple use and low
riscs.
Material and methods: TTT with a 810 nm infrared diode laser and
beam sizes of 1,2 to 3,0 mm for few minutes is practized. Local hyperthermy
leads to consecutive necrosis of tumor tissue. At the university eye hospital
Essen 139 patients have been treated with TTT. Single or primary TTT in
repeated sessions was used for small melanoma in 33 patients, whereas
106 patients with larger melanoma received adjuvant TTT combined with
brachytherapy (ruthenium plaque) using synergistic effects ("sandwich
therapy"). Among these 86 obtained sequential and 20 simultanous
treatment. Complete remission was achieved significantly more frequent
in sandwich therapy than in brachytherapy alone.
Summary: TTT is an useful and effective alternative or addition
to radiation procedures in certain cases of malignant choroidal melanoma.
Indications of transpupillary thermotherapy were shown, practical use,
clinical courses and histopathological results are demonstrated, typical
complications, riscs and restrictions of TTT were described.