title: Plaque radiotherapy for management of ciliary body and choroidal melanoma with extraocular extension.
abstract: OBJECTIVE
  To report the results of plaque radiotherapy of ciliary body and choroidal melanoma with extraocular extension.
  
  
  METHODS
  This retrospective study of 17 eyes of 17 patients with ciliary body and choroidal melanoma demonstrated extraocular extension that was clinically evident but less than 3 mm in thickness. In 14 eyes, the extraocular extension was located anteriorly and in three posteriorly. The outcome of plaque radiotherapy in terms of intraocular and extraocular tumor responses and the development of metastasis were analyzed.
  
  
  RESULTS
  At a median follow-up of 63 months (range, 23 to 164 months) after plaque radiotherapy, all patients showed control of both the intraocular and extraocular components of ciliary body and choroidal melanoma. In no case did the intraocular or extraocular portion of the tumor relapse. The initial median thickness of the intraocular component was 4.9 mm, and the final median thickness was 2.4 mm. The initial median thickness of the extraocular component was 2.0 mm, and the final median thickness was 1.0 mm. The initial median basal diameter of the extraocular component was 3.5 mm, and the final median basal diameter was 2.0 mm. Of 17 patients, 11 (10 with anterior and one with posterior extraocular extension) showed partial regression in base and thickness of the extraocular extension, and in six there was little or no change. In those with anterior extrascleral extension, the sclera remained intact without clinically observable necrosis, and the scleral fibers were gradually more visible as the tumor regressed. Three patients (18%) died of metastatic melanoma at a median interval of 38 months after plaque radiotherapy.
  
  
  CONCLUSIONS
  Plaque radiotherapy appears to be a reasonable treatment option for selected cases of ciliary body and choroidal melanoma with clinically visible extraocular extension less than 3 mm in thickness.
authors.affiliation: Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
authors.forename: K
authors.initials: K
authors.lastname: Gündüz
authors.forename: C L
authors.initials: CL
authors.lastname: Shields
authors.forename: J A
authors.initials: JA
authors.lastname: Shields
authors.forename: J
authors.initials: J
authors.lastname: Cater
authors.forename: L
authors.initials: L
authors.lastname: Brady
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy; D002830:Choroid Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D002924:Ciliary Body / Q000473:pathology / Q000528:radiation effects*; D003037:Cobalt Radioisotopes / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D007496:Iridium Radioisotopes / Q000627:therapeutic use; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D012429:Ruthenium Radioisotopes / Q000627:therapeutic use; D015996:Survival Rate; D016896:Treatment Outcome; D014604:Uveal Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy
chemical_list: D003037:Cobalt Radioisotopes; D007457:Iodine Radioisotopes; D007496:Iridium Radioisotopes; D012429:Ruthenium Radioisotopes