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Raffael Liegl, Christoph Fuerweger, Maren Schmeinck, Jakob Siedlecki, Alexander Muacevic, Ulrich Schaller, Siegfried Priglinger, Paul Foerster; Treatment of uveal melanoma located at the ciliary body using a robotic assisted linear accelerator. Invest. Ophthalmol. Vis. Sci. 2019;60(9):716.
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Choroidal Melanoma is a rare disease, yet the most common primary intraocular malignant finding. Therapy is crucial to reduce risk of metastasis and eventually death. Among choroidal melanoma, those located at the ciliary body are particularly difficult to diagnose and are often larger in size as compared to choroidal melanomas located elsewhere within the uveal tract. Here we report about patients diagnosed with uveal melanoma located at the ciliary body and their response to treatment.
A retrospective case series of 101 eyes of 101 patients treated between 2005 and 2016. All patients had choroidal melanoma located at the ciliary body and were treated using a robotic assisted linear accelerator (Cyberknife). We evaluated local control, rate of recurrence, eye retention rate and overall survival.
The right eye was treated in 52 of the 101 cases and an overall median dose of 21 Gy (17-21 Gy) at an isodose of 70% (60-75%)was delivered. Median follow-up time was 25.8 months.Median iInitial height of tumors were 9.1mm at first diagnosis. Local control was achieved in 86.7% (95%CI: 76.5%-92.6%) of cases within the first 3 years and 73.8% (95%:57.5%-84.7%) at 5 years. Eye retention rate was 86.1% at 3 years and 78.8% at 5 years, while the number of recurrences was 17 out of 101 cases (16.8%). 15 patients were eventually enucleated, 12 of whom due to suspicion of recurrence and 3 due to unmanageable secondary glaucoma. Overal survival was 81.5% after 3 years and 68.5% at 5 years.
Ciliary body melanoma are particularly difficult to diagnose. Our study represent a relatively large cohort of patients with this entity and a median tumor height of 9.1mm. Our results prove that even in this group of patients rather good results can be achieved when being treated with radiation therapy and even though the anterior part of the eye is of higher risk of being affected by treatment, secondary glaucoma rate is not higher as compared to uveal melanoma located differently.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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