Stereotactic radiosurgery of large uveal melanomas with the gamma-knife.
OBJECTIVE
To present our experience with the Gamma-knife in treating large uveal melanomas with stereotactic radiosurgery.


METHODS
Prospective, noncomparative, interventional case series.


METHODS
Fifty-eight patients with unilateral uveal melanomas were treated from 1996 through 1999 with stereotactic radiosurgery using the Gamma-knife. From these we report the results of 35 patients who had a follow-up of more than 1 year after irradiation.


METHODS
Stereotactic radiosurgery with the Gamma-knife.


METHODS
Tumor control, maximum apical tumor height, eye retention rate, and visual acuity.


RESULTS
In 34 eyes (97%), local tumor control was achieved. The maximum apical tumor height decreased from a median of 9.1 mm (95% confidence interval [CI], 3.2-13.9 mm) before treatment to 6.2 mm (95% CI, 2.1-11.9 mm) at 1 year after treatment (P<0.001, paired t test). The tumor volume decreased from a median of 0.8 cm(3) before treatment to 0.5 cm(3) 1 year after treatment (P<0.001, paired t test). Two eyes required enucleation (one radiation failure, one secondary glaucoma). The median visual acuity decreased from 20/60 (95% CI, hand movement [HM] to 20/20) before treatment to 20/200 (95% CI, HM to 20/30) at 1 year after treatment (P = 0.001, paired t test).


CONCLUSIONS
Stereotactic radiosurgery using the Gamma-knife is an alternative to enucleation in treating large uveal melanomas. The visual function may be preserved in selected cases.
Mueller
A J
AJ
Eye Clinic of the University, Klinikum Innenstadt, Muenchen, Germany. amueller@ak-i.med.uni-muenchen.de
Talies
S
S
Schaller
U C
UC
Horstmann
G
G
Wowra
B
B
Kampik
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000601:surgery*; D008875:Middle Aged; D009915:Orbit / Q000473:pathology; D011446:Prospective Studies; D016634:Radiosurgery / Q000379:methods*; D016896:Treatment Outcome; D014604:Uveal Neoplasms / Q000175:diagnosis / Q000601:surgery*; D014792:Visual Acuity