Iodine-125 interstitial brachytherapy for malignant lacrimal sac tumours: an innovative technique

OBJECTIVES: Primary malignant tumours of the lacrimal sac are rare, surgery and radiotherapy may induce substantial side effects for patients. Here, this article reports an innovative technique of interstitial brachytherapy developed for the treatment of malignant lacrimal sac tumours. PATIENTS AND METHODS: Four patients (male 3, female 1), with an average age of 52.7 years (range 41–72 years), were individually diagnosed with squamous cell carcinoma, adenocarcinoma, adenoid cystic carcinoma and lymphoma. All patients received Iodine-125 interstitial brachytherapy after surgical resection for malignant lacrimal sac tumours. Visual function examination (vision, intraocular tension, fundus photography, fluorescein angiography, and optical coherence tomography) and CT/MRI/PET-MRI were performed to look for signs of recurrent tumours or metastasis. RESULTS: Four patients were followed for an average of 28 months (range, 23–37 months). All patients were free from local disease. Their visual function was normal, and CT/MRI did not reveal any tumour recurrence. CONCLUSIONS: Iodine-125 interstitial brachytherapy can be used as an alternative to wide excision or exenteration of these tumours. There was good local control, reasonable maintenance of vision, and good cosmesis.