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Plaque radiotherapy a treatment option for juxtapapillary melanoma
Ophthalmology. 2011;118(2):402-407.
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Plaque radiotherapy can control local tumors associated with juxtapapillary choroidal melanoma, with or without additional transpupillary thermotherapy, according to a study.
The retrospective, comparative case series evaluated 650 consecutive eyes with juxtapapillary choroidal melanoma that had received plaque radiotherapy over a 31-year period.
Approximately 14% of patients had tumor recurrence, 11% had metastasis and 4% died 5 years after therapy. Tumor recurrence increased to 21%, metastasis to 24% and death to 9% 10 years after therapy, with approximately 80% of eyes having local tumor control.
Most eyes (616) received iodine-25 for plaque radiotherapy, and the median radiation dose was 8,000 cGy to the tumor apex. Transpupillary thermotherapy was used in addition to plaque radiotherapy in 307 eyes (56%), but had no statistically significant impact on tumor recurrence or metastasis.
Multivariate analysis confirmed that foveolar tumor requiring transpupillary thermotherapy (P < .001) and greater tumor thickness (P < .001) predicted recurrence. Greater tumor base (P < .001) and increased IOP (P = .02) predicted metastasis.
The tumors had a median basal diameter of 10 mm and a median thickness of 3.5 mm.
Tumors were located immediately next to the optic disc in 481 eyes (74%) and between 0.1 mm and 1.0 mm from the optic disc in 169 eyes.