Malignant melanoma of the eye: treatment of posterior uveal lesions by Co-60 plaque radiotherapy versus enucleation.

Abstract

Survival rates and visual acuity of 100 patients treated for posterior uveal malignant melanoma by cobalt-60 plaque radiotherapy were compared with 150 patients treated by enucleation for the same disease. Life-table comparisons of the entire group showed significant differences in survival rates, with plaque radiotherapy patients appearing to fare better. However, when patients with small or medium tumors were compared, only slight differences were seen, implying that criteria used to select patients for treatment may affect interpretation. The two groups were also compared using the Cox proportional hazards model, which predicts survival based on the impact of clinical variables. In this analysis, the survival rates of the plaque radiotherapy group were no worse than those of the enucleation group. The advantage of conservative therapy lies in the potential to preserve useful vision over a considerable time. Because patients were specifically selected for treatment modality and because the study size used to calibrate the Cox model was small, the results of this study must be interpreted with caution.

Cancer Cure with Organ Preservation Using Radiation Therapy

“…In the interval from May 1976 through July 1987, 595 patients have been treated using cobalt-60 plaques, 131 using iodine-I25 plaques, 102 using ruthenium-106 plaques, and 194 using iridium-192 plaques as a joint venture between the Department of Radiation Oncology at Hahnemann University and the Oncology Service of the Wills Eye Hospital in Philadelphia. A recent assessment was undertaken of 243 patients with malignant posterior uveal melanomas treated in a non-randomized concurrent study (27,8). Of these patients, 143 were treated by enucleation and 97 were managed with cobalt-60 plaque therapy.…”

Treatment of choroidal melanoma by stereotactic radiosurgery

“…Small choroidal melanomas are often treated with episcleral plaque therapy/local resection, while large tumours usually require enucleation. 1,2 …”