title: Stereotactic fractionated radiotherapy in the treatment of juxtapapillary choroidal melanoma: the McGill University experience.
abstract: OBJECTIVE
  To report our experience with linear accelerator-based stereotactic fractionated radiotherapy in the treatment of juxtapapillary choroidal melanoma.
  
  
  METHODS
  We performed a retrospective review of 50 consecutive patients diagnosed with juxtapapillary choroidal melanoma and treated with linear accelerator-based stereotactic fractionated radiotherapy between April 2003 and December 2009. Patients with small to medium sized lesions (Collaborative Ocular Melanoma Study classification) located within 2 mm of the optic disc were included. The prescribed radiation dose was 60 Gy in 10 fractions. The primary endpoints included local control, enucleation-free survival, and complication rates.
  
  
  RESULTS
  The median follow-up was 29 months (range, 1-77 months). There were 31 males and 29 females, with a median age of 69 years (range, 30-92 years). Eighty-four percent of the patients had medium sized lesions, and 16% of patients had small sized lesions. There were four cases of local progression (8%) and three enucleations (6%). Actuarial local control rates at 2 and 5 years were 93% and 86%, respectively. Actuarial enucleation-free survival rates at 2 and 5 years were 94% and 84%, respectively. Actuarial complication rates at 2 and 5 years were 33% and 88%, respectively, for radiation-induced retinopathy; 9.3% and 46.9%, respectively, for dry eye; 12% and 53%, respectively, for cataract; 30% and 90%, respectively, for visual loss [Snellen acuity (decimal equivalent), <0.1]; 11% and 54%, respectively, for optic neuropathy; and 18% and 38%, respectively, for neovascular glaucoma.
  
  
  CONCLUSIONS
  Linear accelerator-based stereotactic fractionated radiotherapy using 60 Gy in 10 fractions is safe and has an acceptable toxicity profile. It has been shown to be an effective noninvasive treatment for juxtapapillary choroidal melanomas.
authors.affiliation: Department of Oncology, Division of Radiation Oncology, Montreal General Hospital, McGill University Health Centre, Montreal, Quebec, Canada.
authors.forename: Rolina
authors.initials: R
authors.lastname: Al-Wassia
authors.forename: Alan
authors.initials: A
authors.lastname: Dal Pra
authors.forename: Kitty
authors.initials: K
authors.lastname: Shun
authors.forename: Ahmed
authors.initials: A
authors.lastname: Shaban
authors.forename: Christine
authors.initials: C
authors.lastname: Corriveau
authors.forename: Chaim
authors.initials: C
authors.lastname: Edelstein
authors.forename: Jean
authors.initials: J
authors.lastname: Deschenes
authors.forename: Russel
authors.initials: R
authors.lastname: Ruo
authors.forename: Horacio
authors.initials: H
authors.lastname: Patrocinio
authors.forename: Fabio L B
authors.initials: FL
authors.lastname: Cury
authors.forename: François
authors.initials: F
authors.lastname: DeBlois
authors.forename: George
authors.initials: G
authors.lastname: Shenouda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000209:etiology; D002830:Choroid Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D015352:Dry Eye Syndromes / Q000209:etiology; D015353:Eye Enucleation / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D011792:Quebec; D016634:Radiosurgery / Q000009:adverse effects / Q000379:methods*; D012160:Retina / Q000528:radiation effects; D012189:Retrospective Studies; D047368:Tumor Burden; D014786:Vision Disorders / Q000209:etiology