Abstract
Purpose: :
To report the outcomes of Gamma Knife radiosurgery (GKRS) in the treatment of uveal melanoma lesions ineligible for standard brachytherapy
Methods: :
A retrospective analysis of uveal melanoma patients treated with GKRS between 1991 and 2004 was performed
Results: :
Five patients with uveal melanoma were treated with GKS between 1991 and 2004. Three of these were iris/ciliary body tumors, 1 was a large choroidal tumor and another was a macular tumor. Adequate globe stabilization was achieved by retrobulbar anesthesia in all cases. Pretreatment visual acuity ranged from 20/20 to 20/50 (mean 20/30).Tumor volume as determined by magnetic resonance imaging ranged from 0.05 to 0.30 cc. Ultrasonographic greatest tumor diameter and height ranged from 11 to 18 mm (mean 14.5 mm) and 2.9 to 4.5 mm (mean 3.6mm), respectively. The peripheral dose varied from 16.5 to 40 Gray. Follow up ranged from 6 to 96 months. Local tumor control was achieved in all cases. Final visual acuity ranged from 20/20 to 20/100 (mean 20/50). One eye developed neovascular glaucoma and was enucleated 8 years following treatment. One patient died 6 years after treatment from liver and lung metastasis. Thus, tumor related death in this series was 20%
Conclusions: :
GKRS for uveal melanoma appears to be safe and effective. The metastasis and mortality rates appear to be comparable to those following brachytherapy and enucleation. Moreover, local tumor control and enucleation rates are similar to those following brachytherapy. The findings in this small series and those from other institutions support a role for GKRS in the treatment of uveal melanomas
Keywords: melanoma • radiation therapy