Incidence of radiation retinopathy after high-dosage single-fraction gamma knife radiosurgery for choroidal melanoma

Haas, Anton; Pintér, Olivér; Papaefthymiou, G.; Weger, Martin; Berghold, Andrea; Schröttner, O.; Müllner, K.; Pendl, G.; Langmann, G.

doi:10.1016/s0161-6420(02)01011-4

Cited by 97 publications

(46 citation statements)

References 22 publications

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“…Alternative treatments include brachytherapy [14,25,26], gamma-knife radiosurgery [27], proton beam radiation [28,29], fractionated stereotactic radiotherapy [30,31], and partial lamellar sclerouvectomy [32]. However, none of these alternative therapies has been evaluated prospectively.…”

Section: Discussionmentioning

confidence: 99%

Ruthenium-106 brachytherapy for thick uveal melanoma: reappraisal of apex and base dose radiation and dose rate

Naseripour¹,

Jaberi²,

Sedaghat³

et al. 2016

jcb

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Purpose: To evaluate the outcomes of ruthenium-106 ( 106 Ru) brachytherapy in terms of radiation parameters in patients with thick uveal melanomas.Material and methods: Medical records of 51 patients with thick (thickness ≥ 7 mm and < 11 mm) uveal melanoma treated with 106 Ru brachytherapy during a ten-year period were reviewed. Radiation parameters, tumor regression, best corrected visual acuity (BCVA), and treatment-related complications were assessed.Results: Fifty one eyes of 51 consecutive patients including 25 men and 26 women with a mean age of 50.5 ± 15.2 years were enrolled. Patients were followed for 36.1 ± 26.5 months (mean ± SD). Mean radiation dose to tumor apex and to sclera were 71 (± 19.2) Gy and 1269 (± 168.2) Gy. Radiation dose rates to tumor apex and to sclera were 0.37 (± 0.14) Gy/h and 6.44 (± 1.50) Gy/h. Globe preservation was achieved in 82.4%. Preoperative mean tumor thickness of 8.1 (± 0.9) mm decreased to 4.5 (± 1.6) mm, 3.4 (± 1.4) mm, and 3.0 (± 1.46) mm at 12, 24, and 48 months after brachytherapy (p = 0.03). Four eyes that did not show regression after 6 months of brachytherapy were enucleated. Secondary enucleation was performed in 5 eyes because of tumor recurrence or neovascular glaucoma. Tumor recurrence was evident in 6 (11.8%) patients. Mean Log MAR (magnification requirement) visual acuity declined from 0.75 (± 0.63) to 0.94 (± 0.5) (p = 0.04). Best corrected visual acuity of 20/200 or worse was recorded in 37% of the patients at the time of diagnosis and 61.7% of the patients at last exam (p = 0.04). Non-proliferative and proliferative radiation-induced retinopathy was observed in 20 and 7 eyes.Conclusions: Thick uveal melanomas are amenable to 106 Ru brachytherapy with less than recommended apex radiation dose and dose rates.

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Section: Discussionmentioning

confidence: 99%

Ruthenium-106 brachytherapy for thick uveal melanoma: reappraisal of apex and base dose radiation and dose rate

Naseripour¹,

Jaberi²,

Sedaghat³

et al. 2016

jcb

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“…In addition, treatment strategies for melanoma and orbital malignancies have changed significantly over the past few decades [8,10]. Initial results utilizing GKR demonstrated good local control, but also resulted in a significant rate of neovascular glaucoma and other toxicities [10,11,12,13]. However, these earlier studies used more aggressive treatment parameters and high marginal doses [13].…”

Section: Discussionmentioning

confidence: 99%

Gamma Knife Stereotactic Radiosurgery for the Treatment of Primary and Metastatic Ocular Malignancies

Arnett

Reynolds

Pulido

et al. 2017

Stereotact Funct Neurosurg

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Background: Gamma knife radiosurgery (GKR) can be used for precise targeting of malignant lesions of the CNS when brachytherapy is not an appropriate option. Objectives: This study reports treatment technique, efficacy, and radiation-induced adverse effects in patients with primary and metastatic ocular lesions treated with Leksell GKR. Methods: A retrospective, single-institution review was conducted of 28 patients with primary or metastatic ocular disease, treated from 2000 to 2014. The dose to margin was 17-27 Gy (maximum dose 28-54 Gy). Primary outcomes included overall survival (OS), local control, progression-free survival (PFS), and enucleation. Results: The median age at diagnosis was 70 years, and the median follow-up was 26.4 months. Of the 28 patients, 11 (39%) had metastatic ocular disease, and 17 (61%) were diagnosed with primary ocular melanoma (stage T2a-T4e). The average maximum dose and dose to margin were 41 and 21 Gy, respectively. The mean dose to the optic nerve was 12.6 Gy. The 5-year OS was 46% (95% CI: 23.6-68.4%) for the entire cohort; the 5-year PFS for M0 patients who presented with primary ocular melanoma lesions was 90% (95% CI: 71-100%). Only 1 patient required enucleation after radiation treatment. Conclusion: GKR is an effective option, with acceptable levels of toxicity, in the treatment of primary and metastatic ocular lesions.

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“…10,11 Radiotherapy of large tumors seems to be associated with increased longterm complications, such as proliferative retinopathy with secondary glaucoma, toxic tumor syndrome, or persistent exudative retinal detachment leading to visual loss or enucleation. 12,13 Therefore, we planned to investigate the effectiveness of a combined radiotherapeutic and surgical treatment of UM not suitable for treatment with ruthenium plaques owing to their size or location. Because single-dose radiation of the OM431 choroidal melanoma cell line resulted in a higher percentage of cell death than did fractionated irradiation, 14 we chose single-dose stereotactic radiotherapy (SDRT) as our approach.…”

Section: N the Past Enucleation Was Thementioning

confidence: 99%

Retrospective Evaluation of Patients With Uveal Melanoma Treated by Stereotactic Radiosurgery With and Without Tumor Resection

Suesskind¹,

Scheiderbauer²,

Buchgeister³

et al. 2013

JAMA Ophthalmol

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Incidence of radiation retinopathy after high-dosage single-fraction gamma knife radiosurgery for choroidal melanoma

Cited by 97 publications

References 22 publications

Ruthenium-106 brachytherapy for thick uveal melanoma: reappraisal of apex and base dose radiation and dose rate

Ruthenium-106 brachytherapy for thick uveal melanoma: reappraisal of apex and base dose radiation and dose rate

Gamma Knife Stereotactic Radiosurgery for the Treatment of Primary and Metastatic Ocular Malignancies

Retrospective Evaluation of Patients With Uveal Melanoma Treated by Stereotactic Radiosurgery With and Without Tumor Resection

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