Gamma-knife-based stereotactic radiosurgery for medium- and large-sized posterior uveal melanoma

Background

This study investigated the use of gamma-knife-based stereotactic radiosurgery (GKRS) for medium- and large-sized posterior uveal melanoma treatment.

Methods

We assessed 50 eyes from 50 consecutive patients with uveal melanoma who were treated with GKRS. All tumors met the criteria for medium- and large-sized uveal melanomas. Patients underwent a single session treatment under local anesthesia; the prescribed radiation dose at the tumor periphery was standardized to 30 Gy at the 50 % isodose field for all patients. The main outcomes were local tumor control, eye retention, and survival rates.

Results

The median follow-up time was 40 months (16–78 months). The baseline mean tumor diameter was 10.3 mm (7.1–15.7 mm) and the apical tumor height was 8.7 mm (4.1–16.8 mm). After treatment, the mean tumor diameter was 8.7 mm (5.5–12.0 mm) and the tumor height was 6.2 mm (0.5–11.2 mm). Changes in both tumor height and diameter were statistically significant (p?p?Conclusion Treatment using low doses of GKRS, (30 Gy) is an eye-sparing outpatient option for patients with medium- or large-sized posterior uveal melanomas who are not eligible for brachytherapy or particle therapy. Complications, particularly impaired VA, should be taken into consideration.