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The following is a summary of “GEC-ESTRO survey of 106Ru eye applicator practice for ocular melanoma – physicist survey,” published in the February 2024 issue of Oncology by Brabandere et al.

This study aims to comprehensively analyze the clinical practices associated with ¹⁰⁶Ru eye plaque brachytherapy (BT), an eye-preserving treatment for uveal melanoma utilized in approximately 100 global clinics. Despite its widespread use, significant variability exists in the application of this intervention. In 2022, the BRAPHYQS and Head & Neck and Skin GEC-ESTRO working groups collaborated on a survey to systematically document current clinical practices. The survey, including both physicist and physician perspectives, focused on aspects such as commissioning and quality control (QC) of plaques, treatment planning, radiobiological correction, as well as broader questions related to practice enhancement. This paper primarily presents the physicist results, incorporating three physician questions with overlapping relevance.

The survey delved into key areas, including the commissioning and QC procedures for plaques, treatment planning methodologies, radiobiological corrections, and broader inquiries to improve overall clinical practice. Notably, the shared questions with the physician survey specifically centered around dose prescription and margins. The results, based on responses from 65 physicists, revealed a prevailing trend of not conducting independent measurements of absorbed dose at reference depth, percentage depth dose (PDD), and off-axis data in most centers. Limited access to calibration services and suitable equipment emerged as primary barriers. A significant finding was that approximately one-third of the centers engaged in image-based treatment planning. Despite guidelines, there needed to be more consistency in using margins and dose prescriptions. Furthermore, a noteworthy portion of respondents expressed a compelling desire for enhancements across various facets of clinical practice.

In conclusion, the physicist survey underscored the extensive variability in the quality control measures associated with ¹⁰⁶Ru sources and the practices related to treatment planning. The study sheds light on areas for potential improvement in the standardization and refinement of clinical approaches within ¹⁰⁶Ru eye plaque brachytherapy, contributing valuable insights to the broader field of interventional radiotherapy for uveal melanoma.

Source: sciencedirect.com/science/article/abs/pii/S0167814024000355