title: Local control and results of Leksell Gamma Knife therapy for the treatment of uveal melanoma.
abstract: OBJECTIVE
  To evaluate the effectiveness of Leksell Gamma Knife stereotactic radio-surgery (Elekta, Stockholm, Sweden) with respect to local tumor control, visual acuity, and radiation side effects for uveal melanoma.
  
  
  METHODS
  Retrospective, non-comparative case series of 23 patients with uveal melanoma treated with Gamma Knife stereotactic radiosurgery at Tufts Medical Center from 2000 to 2012. Patients received single-fraction stereotactic radiation therapy of 20-25 gray (Gy) (mean: 21.7 Gy), primarily at the 50% isodose line. Follow-up was 4 to 121 months (median: 41.5 months). Main outcome measures included local tumor control, metastasis, visual acuity, and complications of therapy.
  
  
  RESULTS
  In 21 of 23 patients (91%), local control was achieved with a single session of Gamma Knife therapy. Both patients who did not have local control, as well as a third patient (three of 23, 13%) developed liver metastases. Visual acuity was 20/200 or better in eight of 23 patients (35%) at last follow-up. Radiation side effects severe enough to cause vision loss were present in 14 of 23 patients (61%).
  
  
  CONCLUSIONS
  Gamma Knife therapy may be an effective alternative to enucleation in patients with uveal melanoma who are deemed less satisfactory candidates for brachytherapy or wish to avoid surgery.
authors.forename: Russell P
authors.initials: RP
authors.lastname: Joye
authors.forename: Lloyd B
authors.initials: LB
authors.lastname: Williams
authors.forename: Michael D
authors.initials: MD
authors.lastname: Chan
authors.forename: Andre J
authors.initials: AJ
authors.lastname: Witkin
authors.forename: Clemens M
authors.initials: CM
authors.lastname: Schirmer
authors.forename: John E
authors.initials: JE
authors.lastname: Mignano
authors.forename: David E
authors.initials: DE
authors.lastname: Wazer
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Yao
authors.forename: Julian K
authors.initials: JK
authors.lastname: Wu
authors.forename: Jay S
authors.initials: JS
authors.lastname: Duker
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary*; D008297:Male; D008545:Melanoma / Q000556:secondary / Q000601:surgery*; D008875:Middle Aged; D011832:Radiation Injuries / Q000209:etiology; D016634:Radiosurgery / Q000009:adverse effects / Q000379:methods*; D012160:Retina / Q000528:radiation effects; D012189:Retrospective Studies; D016896:Treatment Outcome; D014604:Uveal Neoplasms / Q000473:pathology / Q000601:surgery*; D015354:Vision, Low / Q000209:etiology; D014792:Visual Acuity / Q000502:physiology