Literature DB >> 10889116

Stereotactic radiosurgery of large uveal melanomas with the gamma-knife.

A J Mueller1, S Talies, U C Schaller, G Horstmann, B Wowra, A Kampik.   

Abstract

OBJECTIVE: To present our experience with the Gamma-knife in treating large uveal melanomas with stereotactic radiosurgery.
DESIGN: Prospective, noncomparative, interventional case series. PARTICIPANTS: Fifty-eight patients with unilateral uveal melanomas were treated from 1996 through 1999 with stereotactic radiosurgery using the Gamma-knife. From these we report the results of 35 patients who had a follow-up of more than 1 year after irradiation. INTERVENTION: Stereotactic radiosurgery with the Gamma-knife. MAIN OUTCOME MEASURES: Tumor control, maximum apical tumor height, eye retention rate, and visual acuity.
RESULTS: In 34 eyes (97%), local tumor control was achieved. The maximum apical tumor height decreased from a median of 9.1 mm (95% confidence interval [CI], 3.2-13.9 mm) before treatment to 6.2 mm (95% CI, 2.1-11.9 mm) at 1 year after treatment (P<0.001, paired t test). The tumor volume decreased from a median of 0.8 cm(3) before treatment to 0.5 cm(3) 1 year after treatment (P<0.001, paired t test). Two eyes required enucleation (one radiation failure, one secondary glaucoma). The median visual acuity decreased from 20/60 (95% CI, hand movement [HM] to 20/20) before treatment to 20/200 (95% CI, HM to 20/30) at 1 year after treatment (P = 0.001, paired t test).
CONCLUSIONS: Stereotactic radiosurgery using the Gamma-knife is an alternative to enucleation in treating large uveal melanomas. The visual function may be preserved in selected cases.

Entities:  

Mesh:

Year:  2000        PMID: 10889116     DOI: 10.1016/s0161-6420(00)00150-0

Source DB:  PubMed          Journal:  Ophthalmology        ISSN: 0161-6420            Impact factor:   12.079


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