S97
Brachytherapy - Head & neck, skin, eye
ESTRO 2026
References: Mazeron JJ, Ardiet JM, Haie-Meder C, et al. GEC-ESTRO recommendations for brachytherapy for head and neck squamous cell carcinomas. Radiother Oncol. May 2009;91(2):150-6. doi:10.1016/j.radonc.2009.01.005Kovacs G, Martinez- Monge R, Budrukkar A, Guinot JL, Johansson B, Strnad V, et al. GEC-ESTRO ACROP recommendations for head & neck brachytherapy in squamous cell carcinomas: 1st update - Improvement by cross sectional imaging based treatment planning and stepping source technology. Radiother Oncol. 2017;122(2):248-54. Brachytherapy treatment for uveal melanoma, technique implementation in a tertiary hospital. Carmen Escribano 1 , Miren Gaztañaga 1 , Alicia Valverde 2 , Rocío Bermudez 3 , Domingo Cordoba 3 , Manuel Gonzalo Vázquez 1 1 Radiation Oncology, Hospital Clínico San Carlos, Madrid, Spain. 2 Ophtalmology, Hospital Clínico San Carlos, Madrid, Spain. 3 Medical Physics, Hospital Clínico San Carlos, Madrid, Spain Purpose/Objective: Uveal melanoma is a rare tumour, but it is the most common primary intraocular malignancy in adults. It can develop in the choroid, iris, or ciliary body. Treatment options include enucleation, brachytherapy and external beam radiation therapy. A multidisciplinary approach involving ophthalmologists, radiation oncologists, medical physicists, and technicians is required for plaque brachytherapy using either iodine or ruthenium. Our objective is to validate the feasibility of implementing this technique in a public tertiary hospital. Material/Methods: Patients with suspected uveal melanoma are Digital Poster 999 evaluated by a specialist ophthalmologist and referred to the radiation oncology department. Patients are staged using PET-CT. Once the absence of metastatic lesions has been confirmed, the most appropriate local treatment is proposed based on the lesion's location and size. A confirmatory biopsy is only performed in selected cases prior to treatment. Once a patient is considered a brachytherapy candidate, the isotope (Ru-106, I-125) is selected according to the lesion's thickness and location, after which the radiation oncologist prescribes the treatment. The medical physicist then calculates the treatment time according to the clinical parameters. The ophthalmologist then proceeds to perform the brachytherapy implant. The patient remains hospitalised until the plaque is removed. Once this process is complete, the patient is discharged and
continues to attend appointments with both the ophthalmology and radiation oncology teams. Figure 1 shows the clinical pathway for uveal melanoma.
Results: Between January 2019 and August 2025, 95 patients with ocular tumours were assessed in the Radiation Oncology Department. Of these, 80 had uveal melanomas, with 69 receiving treatment at our institution. All cases were presented to the multidisciplinary committee. Table 1 shows the patients’ characteristics and the treatment they received.
Conclusion: The establishment of a multidisciplinary ocular brachytherapy programme for uveal melanoma in a public tertiary hospital has proven to be both feasible and effective. Coordination between the ophthalmology, radiation oncology and medical physics teams enables the safe delivery of treatment and ensures continuity of care. Our experience demonstrates that advanced, eye-preserving therapies can be successfully integrated into public healthcare
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