title: Novel 3D conformal technique for treatment of choroidal melanoma with external beam photon radiotherapy.
abstract: BACKGROUND
  To report a 3D conformal radiotherapy (3D-CRT) technique that utilises a specific eye immobilisation and treatment set-up method as an alternative to stereotactic radiotherapy (SRT), for treatment of juxtapapillary choroidal melanoma (CM) and report early treatment outcomes of this technique.
  
  
  METHODS
  A contact lens and rod system was designed to provide eye immobilisation and a treatment reference point for 3D-CRT. The technique is described in detail in the body of the paper. A retrospective chart review was conducted to report freedom from local progression (FFLP) and radiation toxicity in a cohort of patients treated with a dose of 50 Gy in five fractions.
  
  
  RESULTS
  Eleven eligible patients with juxtapapillary CM were treated between 2003 and 2009. The median follow-up was 3.2 years (range 1.2-5.3). The FFLP was 100% (95% confidence interval 71.5-100). The reproducibility of the set-up and eye immobilisation for fractionation was excellent. The mean dose to the planning target volume was 51.4 Gy (interquartilic range 51.0-51.9). Normal tissue dose constraints were achieved; however, the quality of the 3D-CRT plan was variable. The highest acute radiation toxicity score was Common Toxicity Criteria version 3 grade 1. Vision outcomes were poor.
  
  
  CONCLUSIONS
  In this small series, a novel non-stereotactic technique was found to be an accurate method for the treatment of CM with a high rate of freedom from tumour progression, in keeping with the SRT series. The quality of the conformal plan was variable. Investigation of the optimal dose-fractionation schedule to minimise late radiation toxicity without compromise of tumour control is the focus of ongoing clinical research at our centre.
authors.affiliation: Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia. Claire.Phillips@petermac.org
authors.forename: Claire
authors.initials: C
authors.lastname: Phillips
authors.forename: Kathy
authors.initials: K
authors.lastname: Pope
authors.forename: Colin
authors.initials: C
authors.lastname: Hornby
authors.forename: Brent
authors.initials: B
authors.lastname: Chesson
authors.forename: Jim
authors.initials: J
authors.lastname: Cramb
authors.forename: Mathias
authors.initials: M
authors.lastname: Bressel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002830:Choroid Neoplasms / Q000532:radiotherapy*; D003261:Contact Lenses; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D007103:Immobilization / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D017785:Photons / Q000627:therapeutic use; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated / Q000295:instrumentation* / Q000379:methods*; D016896:Treatment Outcome