Fractionated stereotactic radiotherapy for uveal melanoma, late clinical results

Radiother Oncol. 2012 Feb;102(2):219-24. doi: 10.1016/j.radonc.2011.06.038. Epub 2011 Aug 22.


Purpose: To determine local control, late toxicity and metastatic free survival (MFS) of patients treated with fractionated stereotactic radiation therapy (fSRT) for uveal melanoma (UM).

Methods and materials: Between 1999 and 2007, 102 UM patients were included in a prospective study of a single institution (median follow-up (FU) 32 months; median tumor thickness 6 mm); five fractions of 10 Gy were given. Primary endpoints were local tumor control and late toxicity (including visual outcome and eye preservation). Secondary endpoint was MFS.

Results: Local tumor control was achieved in 96% of the patients. Fifteen enucleations were performed, 2-85 months after radiation. Four eyes were enucleated because of local tumor progression. Nine patients developed grade 3 or 4 neovascular glaucoma (NVG), 19 developed severe retinopathy, 13 developed opticoneuropathy grade 3 or 4, 10 developed cataract grade 3, and 10 patients suffered from keratitis sicca. Best corrected visual acuity (BCVA) decreased from a mean of 0.26 at diagnosis to 0.16, 3 months after radiation and it gradually declined to 0.03, 4 years after therapy. The 5-year actuarial MFS was 75% (95% CIs: 62-84%).

Conclusions: fSRT is an effective treatment modality for uveal melanoma with a good local control. With that, fSRT is a serious eye sparing treatment modality. However, our FU is relatively short. Also, the number of secondary enucleations is substantial, mainly caused by NVG.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Dose Fractionation, Radiation
  • Eye Enucleation
  • Female
  • Humans
  • Logistic Models
  • Male
  • Melanoma / pathology
  • Melanoma / radiotherapy*
  • Melanoma / surgery
  • Middle Aged
  • Neoplasm Staging
  • Prospective Studies
  • Radiotherapy Dosage
  • Stereotaxic Techniques
  • Survival Rate
  • Treatment Outcome
  • Uveal Neoplasms / pathology
  • Uveal Neoplasms / radiotherapy*
  • Uveal Neoplasms / surgery

Supplementary concepts

  • Uveal melanoma