Stereotactic radiotherapy in the treatment of juxtapapillary choroidal melanoma: 2-year follow-up.
OBJECTIVE
To evaluate the efficacy and complications of stereotactic radiotherapy in the management of patients with juxtapapillary choroidal melanoma.


METHODS
Retrospective review.


METHODS
64 patients with juxtapapillary choroidal melanoma.


METHODS
Consecutive patients with juxtapapillary choroidal melanomas located within 2 mm of the optic nerve, treated with stereotactic radiotherapy at Princess Margaret Hospital from October 1998 to January 2006, were reviewed for treatment effect and complication rates.


RESULTS
Median age was 63 years. Median tumor height was 4.2 mm, and median maximum tumor diameter was 9.8 mm. The prescribed radiation dose was 70 Gy in 5 fractions over 10 days, and the median follow-up was 26 months. After treatment, there was local tumor recurrence in 3 patients, and in 8 patients there was systemic progression. Actuarial rates of local tumor control, metastases, and survival at 26 months were 94%, 12%, and 94%, respectively. Rates of radiation-induced neovascular glaucoma, cataract, retinopathy, and optic neuropathy at 26 months were 28%, 45%, 80%, and 52%, respectively. Enucleation was necessary for 7 patients.


CONCLUSIONS
Stereotactic radiotherapy offers a noninvasive alternative with acceptable ocular toxicity rates to enucleation and brachytherapy in the management of juxtapapillary choroidal melanoma.
Somani
Sohel
S
Department of Ocular Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ont. s.somani@utoronto.ca
Sahgal
Arjun
A
Krema
Hatem
H
Heydarian
Mostafa
M
McGowan
Hugh
H
Payne
David
D
Xu
Wei
W
Michaels
Howard
H
Laperriere
Norman
N
Simpson
E Rand
ER
D002830:Choroid Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008545:Melanoma / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D016634:Radiosurgery / Q000379:methods*; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D014792:Visual Acuity