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L. Malaviya, C. Shields, B. Kligman, K. Turaka, A. Mashayekhi, J. Shields; Outcomes of Plaque Radiotherapy for Small (< 3 mm Thickness) Choroidal Melanoma in the Macular Region. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5144.
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To evaluate outcomes of tumor control, treatment complications, and visual acuity following plaque radiotherapy for small (≤ 3 mm thickness) choroidal melanoma in the macular region.
Retrospective chart review of 570 cases.
The median patient age at presentation was 56 years. The most common complaint was decreased vision (55%) while 27% had no symptoms. At presentation, visual acuity was 20/20 to 20/50 in 67%, 20/60-20/100 in 19% and 20/200 or worse in 14%. The median radiation dose to the tumor apex, base and macula was 8000, 17300, and 10350 cGy, respectively. After median follow-up of 40 months, visual acuity was 20/20 to 20/50 in 38%, 20/60 to 20/100 in 14%, and 20/200 or less in 48% (Table1). Local tumor recurrence was found in 9%, controlled by further thermotherapy or radiotherapy in 7% and by enucleation in 2%. Treatment complications included radiation maculopathy in 33% and papillopathy in 16%. Melanoma related mortality occurred in <1%.
Small choroidal melanoma in the macular regions is effectively controlled by plaque radiotherapy (and thermotherapy) in 98% of cases. Radiation damage to the macular and disc region leads to poor visual acuity of 20/200 or worse in 48% patients by median 3.3 years follow up. At that point, mortality is <1%.
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