Clinical experience of stereotactic radiosurgery at a linear accelerator for intraocular melanoma

Abstract

Long-term results with linear accelerator LINAC-based stereotactic radiosurgery for intraocular uveal malignant melanoma were assessed. A retrospective study was carried out of patients with uveal melanoma after a 1-day session stereotactic radiosurgery at LINAC in Slovakia. In the period 2001-2015, a group of 150 patients with uveal melanoma (139 choroidal melanoma, 11 ciliary body melanoma) was treated. The median tumor volume at baseline was 0.5 cm (with range from 0.2 to 1.6 cm). Tumors ranged in size from 2.4 to 20.8 mm in basal diameter and from 2.0 to 18.3 mm in thickness. The therapeutic dose was 35.0 Gy by 99% of dose volume histogram. Older age at treatment was correlated with the largest basal tumor diameter, tumor thickness, and TNM stage. The survival after stereotactic irradiation was 96% in 1 year, 93% in 2 years, 84% in 5 years, 80% in 7 years, and 53% in 11 years. In 20 (13.3%) patients, secondary enucleation was necessary because of complications (secondary glaucoma). Enucleation-free interval ranged from 1 to 6 years. The median age at death was lower (65.7 years) for patients who died from metastatic disease than for those who died from any other cause (75.0 years). Survival rates at 5-year intervals and the need for secondary enucleation because of complications after linear accelerator irradiation are comparable to other techniques.

Uveal Melanoma

“…Because of our outcomes the saw after-treatment decrease in BCVA was not emphatically connected with higher pervasiveness of better BCVA before SRS, however the anatomical outcome after the treatment was at any rate anatomically saved eyeball [17].…”

“…Patient is monitored by an ophthalmologist in 2 weeks, later 6 weeks and 3 months interval -visual acuity, intraocular pressure, slit lamp examination, fundus photo, ultrasound -B-scan, OCT, perimetry. In 3-months' interval patient is send to MRI control [2,17,18].…”

Targeting Epigenetic Modifications in Uveal Melanoma

“…This method is still appropriate for large tumors with extensive extraocular growth and a low probability of retaining vision. However, since in 2006, when the COMS study failed to prove a survival gain with enucleation compared to brachytherapy, there has generally been a movement toward vision- and eye-preserving modalities [ 48 , 49 ]. Tumor size and location, retinal detachment or invasion, and patient age and health status are the main factors affecting clinical management [ 2 ].…”

Pupillary Abnormalities in Childhood – 2 Case Presentations

“…Príčinou môžu byť sekundárne zmeny napr. po chirurgickej liečbe vnútroočných a orbitálnych nádorov, prípadne po ich ožiarení [9,10,11].…”