Ultrasonically induced hyperthermia for adjunctive treatment of intraocular malignant melanoma.
OBJECTIVE
This report describes results of a prospective pilot trial to evaluate the safety and efficacy of hyperthermia as an adjunct to enucleation or brachytherapy in the treatment of patients with intraocular malignant melanoma.


METHODS
Twenty-five patients with intraocular malignant melanomas were treated with ultrasonically induced hyperthermia. In 14 patients, hyperthermia was administered before enucleation (median follow-up period, 44 months), and in 11 patients, hyperthermia was used as an adjunct to brachytherapy (median follow-up period, 79 months).


RESULTS
Patient survival in each group was compared with that of a control group treated with enucleation or brachytherapy alone, using Kaplan-Meier and Cox analysis. Taking into account the simultaneous effects of tumor size and location, the relative risk ratios and 95% confidence bounds associated with adjunctive hyperthermia were 1.68 (range, 0.60-4.72) and 0.68 (range, 0.16-2.89) for the enucleation and brachytherapy groups, respectively.


CONCLUSIONS
Patients receiving adjunctive hyperthermia with brachytherapy showed increased survival, whereas those receiving hyperthermia before enucleation showed decreased survival. Neither trend was statistically significant in this small series. The synergism of hyperthermia with radiation may offer the possibility of improved tumor management.
Coleman
D J
DJ
Department of Ophthalmology, Cornell University Medical College, New York, NY 10021, USA.
Silverman
R H
RH
Ursea
R
R
Rondeau
M J
MJ
Lizzi
F L
FL
D001918:Brachytherapy / Q000379:methods; D015353:Eye Enucleation; D005500:Follow-Up Studies; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D008545:Melanoma / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D010865:Pilot Projects; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant; D012044:Regression Analysis; D012307:Risk Factors; D012449:Safety; D015996:Survival Rate; D016896:Treatment Outcome; D014464:Ultrasonic Therapy / Q000379:methods*; D014604:Uveal Neoplasms / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*