Stereotactic radiosurgery of uveal melanomas: preliminary results with Gamma Knife treatment.
Twelve cases of uveal melanoma (T3N0M0:11 patients, T4N0M0:1 patient) treated with Gamma Knife stereotactic radiosurgery are reported. Our protocol includes preoperative ocular and systemic assessments with complete ocular examination, ophthalmoscopy, fundus photography, fluorangiography, standardized echography, CT and MRI, chest X-rays, liver echography and blood tests. The follow-up program is mainly based on echographic evaluation of tumor thickness and size. The procedures include fixation of the eye, application of the stereotactic Leksell frame G, CT/MRI localization of the melanoma, dose planning and treatment with the Gamma Knife (B type). A mean surface dose of 55 +/- 10 Gy was administered at the 60-90% isodose curve using 4- to 14-mm collimators and a number of shots ranging from 1 to 6. A significant reduction (10-41%) in echographic thickness of the tumor was shown in 6 cases with a follow-up of 3-12 months. In 4 patients, the tumor size was still unchanged after 1-10 months. The single high-dose radiation delivered to the target and the high spatial accuracy are the main advantages of stereotactic radiosurgery for the treatment of posterior uveal melanomas. A longer followup is needed to further validate this new application of Gamma Knife radiosurgery.
Marchini
G
G
University Hospital of Verona, Italy.
Babighian
S
S
Tomazzoli
L
L
Gerosa
M A
MA
Nicolato
A
A
Bricolo
A
A
Piovan
E
E
Zampieri
P G
PG
Alessandrini
F
F
Benati
A
A
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008545:Melanoma / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D016634:Radiosurgery / Q000009:adverse effects; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014604:Uveal Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*