When most people hear the term ocular melanoma, they often think of uveal melanoma, which develops inside the eye. However, another rare form of eye cancer, known as conjunctival melanoma, affects the thin membrane covering the white part of the eye and the inside of the eyelids. Although uncommon, conjunctival melanoma can be aggressive and may spread to nearby tissues or other parts of the body if not treated effectively.
A recently published study from researchers at the University of Crete adds to growing evidence that a specialized form of radiation therapy called Ruthenium-106 (Ru-106) brachytherapy may play an important role in reducing the risk of recurrence after surgery for conjunctival melanoma.
The study evaluated eight patients with either conjunctival melanoma or conjunctival squamous cell carcinoma whose tumors had been surgically removed but had positive or incomplete margins. In these situations, there is concern that microscopic cancer cells may remain behind, increasing the risk of recurrence. To address this risk, patients received adjunctive Ruthenium-106 plaque brachytherapy, a form of localized radiation delivered directly to the treatment area.
Researchers reported an overall local tumor control rate of 75% during follow-up periods ranging from 18 to 75 months. Among the four patients with conjunctival melanoma, three achieved successful local tumor control following treatment. Importantly, no significant radiation-related ocular surface complications were observed during follow-up. Patients did not experience serious problems such as corneal damage, cataract formation, dry eye disease, or tear drainage obstruction.
One of the most interesting aspects of the study is that brachytherapy was used as the sole additional treatment after surgery. No topical chemotherapy, cryotherapy, or immunotherapy was administered to the treated tumor beds. This suggests that carefully planned Ru-106 brachytherapy may be capable of providing meaningful local control while avoiding the cumulative side effects that can occur when multiple treatment approaches are combined.
The authors note that the study was small and retrospective, meaning larger studies will be needed to confirm these findings. However, the results are encouraging and support the growing role of ocular surface brachytherapy in managing selected cases of conjunctival melanoma.
For patients and families facing a conjunctival melanoma diagnosis, this research highlights another important advancement in eye cancer care. As treatment techniques continue to improve, physicians are finding new ways to target cancer effectively while preserving vision, comfort, and quality of life.
Although conjunctival melanoma differs from uveal melanoma, studies like this contribute to the broader goal shared across the ocular oncology community: developing safer, more effective treatments that improve outcomes for patients diagnosed with rare eye cancers.