Stereotactic Radiosurgery and Fractionated Stereotactic Radiation Therapy for the Treatment of Uveal Melanoma

Int J Radiat Oncol Biol Phys. 2017 May 1;98(1):152-158. doi: 10.1016/j.ijrobp.2017.02.017. Epub 2017 Feb 17.

Abstract

Purpose: To evaluate treatment results of stereotactic radiosurgery or fractionated stereotactic radiation therapy (SRS/FSRT) for uveal melanoma.

Methods and materials: We retrospectively evaluated 181 patients with 182 uveal melanomas receiving SRS/FSRT between 2007 and 2013. Treatment was administered with CyberKnife.

Results: According to Collaborative Ocular Melanoma Study criteria, tumor size was small in 1%, medium in 49.5%, and large in 49.5% of the patients. Seventy-one tumors received <45 Gy, and 111 received ≥45 Gy. Median follow-up time was 24 months. Complete and partial response was observed in 8 and 104 eyes, respectively. The rate of 5-year overall survival was 98%, disease-free survival 57%, local recurrence-free survival 73%, distant metastasis-free survival 69%, and enucleation-free survival 73%. There was a significant correlation between tumor size and disease-free survival, SRS/FSRT dose and enucleation-free survival; and both were prognostic for local recurrence-free survival. Enucleation was performed in 41 eyes owing to progression in 26 and complications in 11.

Conclusions: The radiation therapy dose is of great importance for local control and eye retention; the best treatment outcome was achieved using ≥45 Gy in 3 fractions.

MeSH terms

  • Disease-Free Survival
  • Dose Fractionation, Radiation
  • Eye Enucleation / statistics & numerical data
  • Female
  • Humans
  • Male
  • Melanoma / mortality
  • Melanoma / pathology
  • Melanoma / radiotherapy*
  • Melanoma / surgery
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Radiosurgery / adverse effects
  • Radiosurgery / methods*
  • Radiotherapy Planning, Computer-Assisted
  • Retinal Diseases / etiology
  • Retrospective Studies
  • Tumor Burden
  • Uveal Neoplasms / mortality
  • Uveal Neoplasms / pathology
  • Uveal Neoplasms / radiotherapy*
  • Uveal Neoplasms / surgery
  • Visual Acuity