Purchase this article with an account.
Kimberly Chin, Ekaterina Semenova, Paul Finger; Radiation Therapy for Small Choroidal Melanoma: 10-years Experience with Palladium-103 Plaque Radiation Therapy. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4234.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To evaluate outcomes (vision, local control, complications) after ophthalmic plaque radiation therapy for small choroidal melanomas.
Ninety one patients with small choroidal melanomas (<2.5 mm apical height and <10 mm wide) were treated with palladium-103 plaque brachytherapy between 2002-2012. Pre-operative tumor thickness ranged from 1.5 to 2.5 mm (mean 2.2 mm, CI 2.1-2.3 mm). Tumor base diameters ranged from 5.5 to 10.0 mm (mean 8.4 mm, CI 8.2-8.7). Thirty one patients (34.1%) in this study were observed for change from 2 months to 16 years prior to radiation treatment.
Plaque radiotherapy provided local tumor control in 98.9% at a mean 55 months of observation (95% CI 48-62 months). One patient failed treatment. Mean tumor apex dose was 82.3Gy (range 70.0-102 Gy). The most common long-term brachytherapy-related complications were radiation retinopathy (47.3%) and radiation optic neuropathy (19.8%) developing 9 to 72 months after brachytherapy (mean 26 months). These complications were typically stabilized by periodic anti-VEGF intravitreal injections. In this series 85 patients (93.4%) maintained 20/200 or better vision. Metastasis developed in one patient (1.1%).
These findings support palladium-103 plaque radiotherapy as an effective method to treat small choroidal melanomas. While informed consent plays a critical role in small melanoma case selection, treated patients should expect excellent local control rates and better visual acuity outcomes compared to treatment of larger choroidal melanomas.
This PDF is available to Subscribers Only