Comparison of episcleral plaque and proton beam radiation therapy for the treatment of choroidal melanoma
Section snippets
Patients and methods
A retrospective chart review of patients treated with 125I, 106Ru, and PBRT for choroidal melanoma from January 1988 through June 1996 at St. Bartholomew’s Hospital and Moorfields Eye Hospital, London, England, was performed. The following clinical data were extracted from the patients’ medical records: treatment type, age, gender, affected eye, tumor location, tumor height and maximal basal diameter, presence of subretinal fluid, pretreatment visual acuity, visual acuity at last examination,
Results
Clinical features of the patients and tumors are summarized in Table 1. There were 597 patients with unilateral choroidal melanoma identified. The mean age at the time of treatment was 57.1 years (range, 13–87 years; standard deviation [SD], 13.3 years). There were 314 females and 283 males. The right eye was affected in 273 patients, and the left eye was affected in 324 patients. The mean tumor height was 5.8 mm (range, 1.4–15.4 mm; SD, 2.9 mm). The mean tumor maximal basal diameter was 10.8
Discussion
The optimum form of radiation therapy for the treatment of choroidal melanoma has not yet been discovered. Our study does not solve this dilemma. We found that patients treated with 106Ru episcleral plaque radiation therapy had a significantly greater risk of local tumor recurrence than did those patients treated with 125I (P = 0.0133; CI, 1.26–7.02; RR, 2.968) and PBRT (P = 0.0097; CI, 1.30–6.66; RR, 2.941). We were surprised by our findings. Patients treated with 106Ru had tumors with smaller
References (33)
Choroidal sarcoma treated by the intra-ocular insertion of radon seeds
Br J Ophthalmol
(1930)Radiotherapy for malignant melanoma of the choroid
Br J Ophthalmol
(1966)- et al.
Proton-beam irradiated epithelioid cell melanoma of the ciliary body
Ophthalmology
(1981) - et al.
DNA cell cycle studies in uveal melanoma
Am J Ophthalmol
(1989) - et al.
Progress in the use of iodine therapy for tumours of the eye
Br J Radiol
(1980) - et al.
Reasons for enucleation after plaque radiotherapy for posterior uveal melanoma. Clinical findings
Ophthalmology
(1989) - et al.
Palladium 103 plaque radiotherapy for uveal melanoma. Clinical experience
Ophthalmology
(1994) Results after β-irradiation (106Ru/106Rh) of choroidal melanomas20 years’ experience
Br J Ophthalmol
(1986)- et al.
Radiation related complications after ruthenium plaque radiotherapy of uveal melanoma
Br J Ophthalmol
(1996) - et al.
Choroidal melanomaI-125 plaque therapy
Radiology
(1988)