title: Fractionated stereotactic radiotherapy for uveal melanoma, late clinical results.
abstract: OBJECTIVE
  To determine local control, late toxicity and metastatic free survival (MFS) of patients treated with fractionated stereotactic radiation therapy (fSRT) for uveal melanoma (UM).
  
  
  METHODS
  Between 1999 and 2007, 102 UM patients were included in a prospective study of a single institution (median follow-up (FU) 32 months; median tumor thickness 6 mm); five fractions of 10 Gy were given. Primary endpoints were local tumor control and late toxicity (including visual outcome and eye preservation). Secondary endpoint was MFS.
  
  
  RESULTS
  Local tumor control was achieved in 96% of the patients. Fifteen enucleations were performed, 2-85 months after radiation. Four eyes were enucleated because of local tumor progression. Nine patients developed grade 3 or 4 neovascular glaucoma (NVG), 19 developed severe retinopathy, 13 developed opticoneuropathy grade 3 or 4, 10 developed cataract grade 3, and 10 patients suffered from keratitis sicca. Best corrected visual acuity (BCVA) decreased from a mean of 0.26 at diagnosis to 0.16, 3 months after radiation and it gradually declined to 0.03, 4 years after therapy. The 5-year actuarial MFS was 75% (95% CIs: 62-84%).
  
  
  CONCLUSIONS
  fSRT is an effective treatment modality for uveal melanoma with a good local control. With that, fSRT is a serious eye sparing treatment modality. However, our FU is relatively short. Also, the number of secondary enucleations is substantial, mainly caused by NVG.
authors.affiliation: Department of Radiation-Oncology, Erasmus Medical Center, Rotterdam, The Netherlands. karin.muller@kpnplanet.nl
authors.forename: Karin
authors.initials: K
authors.lastname: Muller
authors.forename: Nicole
authors.initials: N
authors.lastname: Naus
authors.forename: Peter J C M
authors.initials: PJ
authors.lastname: Nowak
authors.forename: Paul I M
authors.initials: PI
authors.lastname: Schmitz
authors.forename: Connie
authors.initials: C
authors.lastname: de Pan
authors.forename: Cornelis A
authors.initials: CA
authors.lastname: van Santen
authors.forename: Johannes P
authors.initials: JP
authors.lastname: Marijnissen
authors.forename: Dion A
authors.initials: DA
authors.lastname: Paridaens
authors.forename: Peter C
authors.initials: PC
authors.lastname: Levendag
authors.forename: Gré P M
authors.initials: GP
authors.lastname: Luyten
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019583:Dose Fractionation, Radiation; D015353:Eye Enucleation; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008545:Melanoma / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D013238:Stereotaxic Techniques; D015996:Survival Rate; D016896:Treatment Outcome; D014604:Uveal Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D000098943:Uveal Melanoma