title: BRACHYTHERAPY ALONE OR WITH NEOADJUVANT PHOTODYNAMIC THERAPY FOR AMELANOTIC CHOROIDAL MELANOMA: Functional Outcomes and Local Tumor Control.
abstract: OBJECTIVE
  To compare visual outcomes and local tumor control between two groups of patients with amelanotic choroidal melanoma treated with brachytherapy alone, or neoadjuvant photodynamic therapy before brachytherapy.
  
  
  METHODS
  Patients diagnosed with amelanotic choroidal melanoma were recruited for the study and divided into two groups: brachytherapy alone (Group A) and photodynamic therapy preceding brachytherapy (Group B). Patients of both groups were selected to be comparable.
  
  
  RESULTS
  Twenty-six patients with amelanotic choroidal melanoma were enrolled in the study. Within Group B, 1 month after photodynamic therapy, ultrasonography showed reduction of tumor height in 11 patients (73.4%). The mean doses of irradiation to macula and optic nerve, at baseline were 74.37 and 52.07 Gy, whereas after photodynamic therapy there was a decrease of 17.26% (P = 0.008) and 21.22% (P = 0.025), respectively. In terms of visual acuity, a mean decrease of 14 ETDRS letters and 5 ETDRS letters was observed at 24 months follow-up, in Groups A and B, respectively (P = 0.001).
  
  
  CONCLUSIONS
  Photodynamic therapy as neoadjuvant therapy before brachytherapy reduces tumor thickness in 73.4% of cases. As a result, a decrease of radiation toxic effects on visual function could be obtained, without compromising disease control.
authors.affiliation: Departments of *Ophthalmology, and †Radiation Oncology, Catholic University, Rome, Italy.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Blasi
authors.forename: Michela
authors.initials: M
authors.lastname: Laguardia
authors.forename: Luca
authors.initials: L
authors.lastname: Tagliaferri
authors.forename: Andrea
authors.initials: A
authors.lastname: Scupola
authors.forename: Antonio
authors.initials: A
authors.lastname: Villano
authors.forename: Carmela G
authors.initials: CG
authors.lastname: Caputo
authors.forename: Monica M
authors.initials: MM
authors.lastname: Pagliara
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy; D002830:Choroid Neoplasms / Q000188:drug therapy / Q000503:physiopathology / Q000532:radiotherapy / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008297:Male; D018328:Melanoma, Amelanotic / Q000188:drug therapy / Q000503:physiopathology / Q000532:radiotherapy / Q000628:therapy*; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use; D011166:Porphyrins / Q000627:therapeutic use; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D012429:Ruthenium Radioisotopes / Q000627:therapeutic use; D000077362:Verteporfin; D014792:Visual Acuity / Q000502:physiology*
chemical_list: D007457:Iodine Radioisotopes; D017319:Photosensitizing Agents; D011166:Porphyrins; D012429:Ruthenium Radioisotopes; D000077362:Verteporfin