[Long-term results of cobalt 60 curietherapy for uveal melanoma].
OBJECTIVE
To analyze 65 patients with uveal melanomas treated with cobalt plaque therapy with regards to mortality, visual results and complications.


METHODS
Most of the melanomas were large (T3: 52.5%), with a mean largest dimension of the base of 11 mm, and a mean thickness of 6 mm. Most of the tumors were located in the choroid (95%), with an anterior margin behind the equator (65%), and a posterior margin at less than 3 mm of the disc and/or of the macula (69%). The plaque radiotherapy delivered a mean dose of 95 Gy to the tumor apex, either with a cobalt plaque alone (51 cases), or in association with a ruthenium plaque (14 cases). The mean follow up period was over 8 years.


RESULTS
The local control was achieved initially in 86% of the eyes. The estimated melanoma specific survival rate was 83% after 5 years and 74% after 10 years. The main parameter associated with the metastases was the largest dimension of the base (p < 0.01). The eye was retained in 83% of the cases. The probability of keeping a vision better than or equal to 0,1 was 39% after 5 years and 27% after 10 years. The main parameter associated with the visual loss was the tumor size (p < 0.01). The complications included cataract (39%), radiation retinopathy (34%), with maculopathy (19%) and/or papillopathy (13.5%), vitreous hemorrhages (22%), neovascular glaucoma (15%) and retinal detachment (12%).


CONCLUSIONS
These results supported the value of cobalt plaque radiotherapy in the management of uveal melanomas.
Bacin
F
F
Clinique Ophtalmologique du CHRU, Hôpital Gabriel Montpied, Clermont-Ferrand.
Kwiatkowski
F
F
Dalens
H
H
Rozan
R
R
Gagyi
S
S
Donnarieix
D
D
Bard
J J
JJ
Robert
J L
JL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects; D002830:Choroid Neoplasms / Q000532:radiotherapy / Q000601:surgery; D003037:Cobalt Radioisotopes / Q000627:therapeutic use*; D005069:Evaluation Studies as Topic; D015353:Eye Enucleation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011832:Radiation Injuries / Q000209:etiology; D012429:Ruthenium Radioisotopes / Q000627:therapeutic use; D015996:Survival Rate; D016896:Treatment Outcome; D014604:Uveal Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D014792:Visual Acuity
D003037:Cobalt Radioisotopes; D012429:Ruthenium Radioisotopes
Résultats à long terme de la curiethérapie par le cobalt 60 des mélanomes de l'uvée.