Stereotactic Radiosurgery Of Uveal Melanoma With And Without Tumor Resection With Respect To Local Tumor Control And Eye Retention

Abstract

Purpose: : To evaluate single dose stereotactic radiotherapy (RT) of uveal melanoma (UM) alone and with combined tumor resection with respect to local tumor control and eye preservation as major outcome parameters and visual acuity, development of radiation complications (RC), metastases and death as minor outcome parameters.

Methods: : Retrospective analysis of 78 patients with primary UM treated by RT alone (group 1: 49 patients) or with combined tumor resection (group 2: 29 patients) between june 2003 and march 2008. Radiation was performed with a linear accelerator and a single tumor surrounding dose of 25Gy. A modified swim goggle holding a light spot as an optical guide for active fixation of the eye was used to immobilise the eye during RT.

Results: : Within a median follow-up (FU) of 33.7 months (range: 0.13-81.13months) 6 recurrences (7.75%) occurred only in group 1 (p=0.077). Kaplan-Meier-analysis revealed a tumor control rate of 81.7% after 24 months for group 1 and 100% for group 2 (p=0.077). Eye retention rate was 84.4% and 92.6% after 24 months for group 1 and group 2, respectively (p=0.799). Mean visual acuity decreased in both groups (p=0.000). More radiation complications (RC) occurred in group 1 in comparison to group 2 (p=0.01). No difference was observed with respect to development of metastases (p=0.7) and death (p=0.07).

Conclusions: : Stereotactic RT with combined tumor resection achieves a better tumor control than RT alone and much less RC. Both groups have similar eye retention rates and are comparable concerning the dramatic decrease in visual function in the majority of eyes.

Keywords: tumors • melanoma • radiation therapy