Dose De-Escalation With Gamma Knife Radiosurgery in the Treatment of Choroidal Melanoma

Local tumour control and eye preservation after gamma-knife radiosurgery of choroidal melanomas

“…Over time, we lowered the treatment dose in a stepwise manner to reduce radiation-induced side effects 17. This is in accordance with reports by other authors, who reduced the treatment dose and successfully applied low-dose regimens for stereotactic radiosurgery 11 18 19. Uveal melanoma is generally considered a radioresistant tumour that responds well to high-dose hypofractionated treatment 20.…”

“…Our results further support previous reports, which failed to show an impact of lower treatment dose on tumour control but did observe improved eye preservation. Thus, our findings encourage further efforts to identify the optimal treatment dose for the radiotherapy of choroidal melanoma 17 18…”

Predictors of radio-induced visual impairment after radiosurgery for uveal melanoma

“…Gamma Knife stereotactic radiosurgery (GKRS) is a well-assessed strategy for conservative treatment of UM providing satisfactory results in terms of survival, local tumour control and eye preservation 8 9. A wide range of prescription radiation doses (from 20 to 80Gy) was used in published series of GKRS for UMs,10–12 showing a de-escalation trend over the years with the aim of reducing side effects 13. Actually, several complications following GKRS have been reported, with a complication rate ranging from 55% to 82% in the different studies 14 15.…”

Neovascular Glaucoma After Stereotactic Radiotherapy for Juxtapapillary Choroidal Melanoma: Histopathologic and Dosimetric Findings

“…With respect to treatment modalities, brachytherapy with standard plaque radiotherapy has been cautioned against because of the physical difficulty of positioning a plaque close to the optic nerve head where tilting can result in tumor underdosing (3). Alternatively, external beam radiotherapy has been used successfully with protons or charged particles (4), Gamma Knife technology (5), or linear accelerator-based stereotactic radiotherapy (SRT) (6)(7)(8). The aim of radiation as opposed to enucleation is tumor control with organ preservation; however, radiationinduced complications can still result in enucleation.…”