Primary Tumor Radiation Treatment

Brachytherapy ("Plaque Therapy")

Also known as sealed source radiotherapy or endocurietherapy, brachytherapy is the most common form of radiation treatment for OM.

With plaque therapy, a small disc-shaped shield known as a plaque encasing radioactive seeds (most often Iodine-125, though Ruthenium-106 and Palladium-103 can also be used) is attached to the outside surface of the eye, overlying the tumor. It is customized for you and your tumor.

The plaque is left in place for a few days (6 days is not atypical) and then removed. Brachytherapy is commonly used to treat OM as well as localized prostate cancer, cervical cancer, and other cancers of the head and neck.

Dr. Finger has a good overview of plaque therapy on his Eye Cancer Foundation site.

Teletherapy (external beam radiotherapy)

  • Proton beam therapy - Proton therapy is an advanced form of radiation therapy that sends a powerful beam of protons to the precise site of a tumor. Once the proton beam reaches the tumor, it conforms to its shape and depth, and only then releases its full energy. It then stops, sparing surrounding tissue. (read more at MD Anderson overview)
  • Gamma Knife RT
  • Charged particle RT
  • Stereotactic Linac RT

Transpupillary thermotherapy (TTT)

A technique in which heat is delivered to the choroid and retinal pigment epithelium through the pupil using a modified diode laser. This laser technique contrasts with the nonthermal laser used in standard photocoagulation therapy which is designed to activate verteporfin, a photosensitizing agent. TTT uses a lower power laser for more prolonged periods of time and is designed to gently heat the choroidal lesion, thus limiting damage to the overlying retinal pigment epithelium. TTT is used less frequently in OM treatment due to issues with final control and recurrence.