Purpose:
To evaluate the long term safety and efficacy of palladium-103 plaque radiation therapy for uveal melanoma.
Methods:
A retrospective review of the results of 384 consecutively treated patients was performed. Each was treated over 5-7 continuous days, to a mean apex dose of 71 Gy. They were evaluated for tumor and patient specific characteristics as well as local control, visual acuity and eye retention.
Results:
There were 233 tumors posterior to the equator, 27 equatorial and 122 anterior melanomas. By AJCC-UICC classification there were 69-T1, 293-T2, 17-T3 and 4-T4 melanomas. In 1990, we treated the first patient with palladium-103 ophthalmic plaque radiation therapy for choroidal melanoma. Now, 17-years later, the maximum follow-up is 205 months (mean, 47 months). There have been 13 incidents of tumor regrowth for a 97% local radiation control rate. Only 3% have required secondary enucleation. Best corrected visual acuities are 20/200 or better in 76% (291/384). This may be due (in part) to laser and bevacizumab treatment to prevent and/or treat radiation optic neuropathy and maculopathy.
Conclusions:
At The New York Eye Cancer Center, palladium-103 ophthalmic plaque brachytherapy has provided local control and eye retention rates equivalent to or superior than published alternative radiation methods. Our visual acuity outcomes are markedly superior (Table).
Keywords: melanoma • uvea • radiation therapy