S105
Brachytherapy - Head & neck, skin, eye
ESTRO 2026
tolerance are described in the literature, data on corneal radiation tolerance in the context of brachytherapy remain limited, and no clear dose– toxicity relationships have been reported to date. This lack of documented corneal toxicity profiles is particularly relevant when treating tumors involving or located near the anterior segment, where higher corneal doses may be unavoidable. In this retrospective study, we evaluated two clinical scenarios involving anterior ocular lesions: (1) primary treatment of uveal tumors located in the iris or ciliary body, and (2) adjuvant brachytherapy for conjunctival melanoma with limbal corneal extension or squamous neoplasia involving the corneal surface. The primary objective of this analysis was to assess corneal toxicity in patients undergoing Ru-106 brachytherapy for anterior ocular lesions, by correlating delivered corneal dose parameters with clinical outcomes. Material/Methods: A retrospective analysis was conducted on 20 patients treated with Ru-106 episcleral plaques between 2019 and 2025 at our center. Only patients with anteriorly located lesions were included. For each case, scleral dose, maximum corneal dose (Gy), and mean corneal dose (Gy) were extracted from the treatment planning system. Clinical follow-up data were reviewed to assess ocular tolerance and radiation-induced toxicity. Results: The mean dose delivered to the sclera was 241.4 Gy (range: 99.9–489.7 Gy). The mean of the maximum corneal dose was 228.3 Gy (range: 64.6–496.4 Gy), and the mean of the average corneal dose was 55.3 Gy (range: 8.7–101.7 Gy). Across all patients, no acute or late corneal or scleral toxicity was observed during follow-up. In particular, no cases of keratitis, corneal ulceration, scleral necrosis, or vision-threatening complications were recorded. All treatments were completed as planned without the need for dose reduction or early plaque removal. Conclusion: Our findings show that Ru-106 brachytherapy for anterior ocular lesions is well tolerated, even in cases with high corneal dose exposure. The absence of corneal toxicity in this cohort supports the safety of Ru-106 plaque therapy when treatment planning and plaque positioning are optimized. These results also highlight the need for future multicenter studies to define evidence-based corneal dose constraints in ocular brachytherapy. Keywords: Brachytherapy, interventional radiotherapy, cornea
Conclusion: Alginate effectively reduced air-gap–related dose losses, improving CTV coverage and implant stability. The study supports the clinical use of TG-186 for accurate dose evaluation in anatomically complex regions such as the auricle, emphasizing the importance of patient-specific geometry and support materials in IRT treatment optimization. Keywords: NMSC, interventional radiotherapy, skin References: [1] Nath R, Anderson LL, Luxton G et al. Dosimetry of interstitial brachytherapy sources: Recommendations of the AAPM Radiation Therapy Committee Task Group No. 43. Med Phys 1995; 22: 209-234. [2] Beaulieu, L.; Carlsson Tedgren, Å.; Carrier, J.F.; Davis, S.D.; Mourtada, F.; Rivard, M.J.; Thomson, R.M.; Verhaegen, F.; Wareing, T.A.; Williamson, J.F. Report of the Task Group 186 on model-based dose calculation methods in brachytherapy beyond the TG-43 formalism: Current status and recommendations for clinical implementation. Med. Phys. 2012, 39, 6208– 6236 Dose to cornea in Ruthenium-106 ocular interventional radiotherapy (modern brachytherapy) Elisa Placidi 1 , Sofia Raponi 2 , Enrico Rosa 1,3 , Bruno Fionda 1 , Maria Grazia Sammarco 1 , Maria Vaccaro 1 , Monica Maria Pagliara 4 , Gustavo Savino 4 , Luca Tagliaferri 1,5 , Marco De Spirito 1,2 1 Dipartimento di Diagnostica per Immagini e Radioterapia Oncologica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. 2 Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, Rome, Italy. 3 Department of Theoretical and Applied Sciences, eCampus University, Rome, Italy. 4 Dipartimento Neuroscienze, Organi di Senso e Torace, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. 5 Dipartimento di Scienze Radiologiche, Università Cattolica del Sacro Cuore, Rome, Italy Purpose/Objective: Ruthenium-106 (Ru-106) plaque brachytherapy is an established treatment for uveal melanoma and other ocular tumors. While dosimetric constraints regarding scleral Digital Poster 4338
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