Effectiveness of fractionated stereotactic radiotherapy for uveal melanoma.
OBJECTIVE
To study the effectiveness and acute side effects of fractionated stereotactic radiation therapy (fSRT) for uveal melanoma.


METHODS
Between 1999 and 2003, 38 patients (21 male, 17 female) were included in a prospective, nonrandomized clinical trial (mean follow-up of 25 months). A total dose of 50 Gy was given in 5 consecutive days. A blinking light and a camera (to monitor the position of the diseased eye) were fixed to a noninvasive relocatable stereotactic frame. Primary end points were local control, best corrected visual acuity, and toxicity at 3, 6, 12, and 24 months, respectively.


RESULTS
After 3 months (38 patients), the local control was 100%; after 12 months (32 patients) and 24 months (15 patients), no recurrences were seen. The best corrected visual acuity declined from a mean of 0.21 at diagnosis to 0.06 2 years after therapy. The acute side effects after 3 months were as follows: conjunctival symptoms (10), loss of lashes or hair (6), visual symptoms (5), fatigue (5), dry eye (1), cataract (1), and pain (4). One eye was enucleated at 2 months after fSRT.


CONCLUSIONS
Preliminary results demonstrate that fSRT is an effective and safe treatment modality for uveal melanoma with an excellent local control and mild acute side effects. The follow-up should be prolonged to study both long-term local control and late toxicity.
Muller
Karin
K
Department of Radiation Oncology, Erasmus Medical Center, Rotterdam, The Netherlands.
Nowak
Peter J C M
PJ
de Pan
Connie
C
Marijnissen
Johannes P
JP
Paridaens
Dion A
DA
Levendag
Peter
P
Luyten
Gré P M
GP
D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D008545:Melanoma / Q000401:mortality / Q000532:radiotherapy*; D008875:Middle Aged; D011446:Prospective Studies; D016634:Radiosurgery / Q000009:adverse effects / Q000379:methods*; D012163:Retinal Detachment / Q000628:therapy; D014604:Uveal Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D014792:Visual Acuity / Q000528:radiation effects