Plaque Radiotherapy for Management of Small Choroidal Melanoma: A Series of 1251 Cases

Abstract

Purpose: : To report the tumor control and treatment complications of plaque radiotherapy for small choroidal melanoma.

Methods: : Retrospective non-comparative chart review of 1251 affected patients.

Results: : The median age at presentation was 58 years and mean age was 57 years (Range 13-87 years). The most common presenting symptom was decreased vision (37%) and the median tumor basal diameter was 8.0 mm and median thickness 2.7 mm. Median radiation dose to the tumor apex was 8000 cGy and tumor base was 17500 cGy. After a median follow-up of 58 months, the tumor thickness regressed by a median of 63%. Local tumor recurrence at 2-year, 5-year, and 10-year follow up was 1.8%, 4.8%, and 6.6% respectively. Visual acuity of 20/50 or better was maintained in 65% of patients at 2 years, 52% at 5 years, and 48% at 10 years. The most common treatment-related complications were radiation maculopathy (36%) and radiation papillopathy (17%). There were 50 patients (4%) with evidence of systemic metastasis.

Conclusions: : Plaque radiotherapy is an effective treatment for small choroidal melanoma with low rates of local tumor recurrence and systemic metastasis. Nearly 50% of patients maintained visual acuity of 20/50 or better at 10 years of follow up.

Keywords: melanoma • choroid • radiation therapy