title: Stereotactic radiotherapy in the treatment of juxtapapillary choroidal melanoma: 2-year follow-up.
abstract: 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.
authors.affiliation: Department of Ocular Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ont. s.somani@utoronto.ca
authors.forename: Sohel
authors.initials: S
authors.lastname: Somani
authors.forename: Arjun
authors.initials: A
authors.lastname: Sahgal
authors.forename: Hatem
authors.initials: H
authors.lastname: Krema
authors.forename: Mostafa
authors.initials: M
authors.lastname: Heydarian
authors.forename: Hugh
authors.initials: H
authors.lastname: McGowan
authors.forename: David
authors.initials: D
authors.lastname: Payne
authors.forename: Wei
authors.initials: W
authors.lastname: Xu
authors.forename: Howard
authors.initials: H
authors.lastname: Michaels
authors.forename: Norman
authors.initials: N
authors.lastname: Laperriere
authors.forename: E Rand
authors.initials: ER
authors.lastname: Simpson
mesh_terms: 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