[Curietherapy of palpebral epithelioma with iridium-192. Method and results apropos of 192 cases treated at the Claudius-Regaud Center].

Authors report a series of 192 eyelid epithelial tumors (187 patients) treated by curietherapy (192 iridium) at the Centre Claudius-Regaud, from January 1977 to December 1982. Curietherapy is an interstitial radiotherapy technique which inserts radio-active lines directly in the epithelial area. The first part of treatment consisted in using disposable vascular catheters as after loading procedure. In 90% of the cases, lesions were either on the lower lid or on the inner canthus. Tumors were mainly of basal cell type (77%). One thousand forty one tumors occurred in untreated patients: treatment was made for local recurrences in 51 cases. The control rate was 97% (186/192). Six recurrences were all observed in basal cell carcinoma. Four of them were cured by a second curietherapy, the two others needed a large surgical enucleation followed in one case by external radiotherapy. Late side effects essentially were functional and ocular. Functional side effects (19% of the series) consisted in eyelid hole reduction (5%), epiphora stenosis (6%), ectropion (4%) and loss of substance (4%). Ocular complications (3% of the series), were ulcerated cornea (one case) hypertrophic conjunctivitis (one case), iatrogenic cataract (two cases) and enucleation for recurrence (two cases). Iridium 192 curietherapy allowed a high local control rate. The best results were seen in untreated patients. Iatrogenic cataract eventually would be avoided by the use of lead contact lenses (recent utilisation not included in this series).