Iodine brachytherapy as an alternative to enucleation for large uveal melanomas☆
Section snippets
Aims of the study
The primary aim was to assess survival and local tumor control in a population-based, consecutive group of patients who underwent primary I125 episcleral IBT for a uveal melanoma that was large by the COMS criteria. A secondary goal was to evaluate its efficacy in retaining vision and cosmesis.
Inclusion criteria
Eligible for this study were patients who were diagnosed with a uveal melanoma that met the COMS criteria of large tumor (largest basal diameter [LBD] >16.0 mm and height >2.0 mm, height >10.0 mm
Results
The median age at diagnosis of the 97 enrolled patients (male:female, 49:48), all white persons, was 64 years (range, 24–82 years). The median follow-up time was 3.6 years (range, 0.3–10.5 years).
Discussion
The 5-year all-cause and melanoma-specific mortality of patients who had a large uveal melanoma managed with IBT seemed to be comparable with that reported for enucleation only in the COMS Large Tumor Study16 and in other studies with predominantly large uveal melanomas.32, 33 This is despite that, unlike COMS, we did not exclude patients who had a history of major illness, other cancer, or metastases at diagnosis. The median LBD was slightly smaller than in the COMS Large Tumor Study,16 but
Acknowledgements
The authors thank Petri Tommila, MD, Ilkka Immonen, MD, Juha Rajaste, MD, and Kimmo Liesto, MD, Vitreoretinal Service, Department of Ophthalmology, Helsinki University Central Hospital, for performing 30 of the brachytherapy surgeries.
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Manuscript no. 220562.
Supported by The Eye Foundation, The Eye and Tissue Bank Foundation, Finnish Medical Foundation, and The Helsinki University Central Hospital Research Fund (TYH1217), Helsinki, Finland.
The authors have no proprietary interest in the technique or equipment described.