title: Short course palliative radiotherapy in the management of choroidal metastasis: An effective technique since ages.
abstract: OBJECTIVE
  Uveal tract is the most common site of intra-ocular metastasis. Overall, the reported prevalence of clinically evident uveal metastases in patients with cancer ranges from 2% to 9%, with the majority of the cases being due to breast cancer. We aimed at evaluating the role of palliative radiotherapy in the management of choroidal metastasis from carcinoma breast.
  
  
  METHODS
  We describe the clinico-pathologic features, treatment and outcome of ten patients of carcinoma breast who presented to the ophthalmology department at our institution with ocular symptoms attributable to choroidal metastasis.
  
  
  RESULTS
  Nine of the patients were female while one was male. All of them presented with painless progressive diminution of vision. Median duration of symptoms was 2.25 months. Five patients had associated lung metastasis while bone and brain metastases were seen in three and two patients respectively. All of them received palliative radiotherapy (RT) to the involved eye (or eye+brain) by 3D-CRT (n=7), or 2 Dimensional technique (n=2) or electron therapy (n=1). Doses prescribed were 30 Gy/10#/2 weeks (n=8); 20 Gy/5 #/1 week (n=2). Simultaneously they received hormonal therapy (n=6) or systemic chemotherapy (n=3). After a median follow up of 18 months seven patients had complete resolution and two patients had partial resolution of the metastases.
  
  
  CONCLUSIONS
  Short course palliative radiation therapy is an effective modality for the management of choroidal metastasis in patients of carcinoma breast. In the current report it led to formidable local control with acceptable radiation induced toxicity.
authors.affiliation: Department of Radiation Oncology, Dr. B.R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi 110029, India. Electronic address: soumyajitroy8@gmail.com.
authors.forename: Soumyajit
authors.initials: S
authors.lastname: Roy
authors.affiliation: Department of Radiation Oncology, Dr. B.R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi 110029, India.
authors.forename: Renu
authors.initials: R
authors.lastname: Madan
authors.affiliation: Department of Medical Oncology, Dr. B.R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi 110029, India.
authors.forename: Ajay
authors.initials: A
authors.lastname: Gogia
authors.affiliation: Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi 110029, India.
authors.forename: Koushik
authors.initials: K
authors.lastname: Tripathy
authors.affiliation: Department of Radiation Oncology, Dr. B.R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi 110029, India.
authors.forename: Dayanand
authors.initials: D
authors.lastname: Sharma
authors.affiliation: Department of Radiation Oncology, Dr. B.R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi 110029, India.
authors.forename: Pramod Kumar
authors.initials: PK
authors.lastname: Julka
authors.affiliation: Department of Radiation Oncology, Dr. B.R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi 110029, India.
authors.forename: Goura Kishore
authors.initials: GK
authors.lastname: Rath
mesh_terms: D002830:Choroid Neoplasms / Q000175:diagnosis / Q000532:radiotherapy* / Q000556:secondary*; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019721:Ophthalmoscopes; D010166:Palliative Care; D018714:Radiotherapy, Adjuvant / Q000379:methods; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome
keywords: Carcinoma breast; Choroidal metastasis; Palliative radiotherapy; Uveal metastasis