Umit Yasar Guleser1, Ahmet Murat Sarici2, Didar Ucar3, Busenur Gonen4, Nilay Sengul Samanci5, Mustafa Özgüroğlu5. 1. Department of Ophthalmology, Sivas Numune Hospital, Sivas, Turkey. 2. Department of Ophthalmology, Cerrahpasa Medical Faculty, Istanbul Unıversity - Cerrahpasa, Istanbul, 34098, Turkey. ahmetsarici@gmail.com. 3. Department of Ophthalmology, Cerrahpasa Medical Faculty, Istanbul Unıversity - Cerrahpasa, Istanbul, 34098, Turkey. 4. Department of Ophthalmology, Zonguldak Ataturk State Hospital, Zonguldak, Turkey. 5. Department of Internal Medicine, Division of Medical Oncology, Cerrahpaşa Medical Faculty, Istanbul University - Cerrahpasa, Istanbul, Turkey.
Abstract
PURPOSE: To compare the efficacies of iodine-125 brachytherapy (IBT) and gamma knife stereotactic radiosurgery (GKRS) in the treatment of posterior uveal melanoma. METHODS: The demographic data and tumor characteristics at diagnosis of 201 patients treated with IBT and 52 patients treated with GKRS were recorded. The two treatments were then compared in terms of complications, local control, eye retention, metastasis, and overall survival rate. RESULTS: The median follow-up time was 56 months for the GKRS group and 45 months for the IBT group (p = 0.167). There were no significant differences in demographic data or tumor characteristics between the groups at diagnosis. Radiation retinopathy, radiation optic neuropathy, and neovascular glaucoma occurred at similar rates in both groups. However, radiation maculopathy and cataracts occurred more frequently in the GKRS group. The number of cases that have developed vision loss (worsening of best-corrected visual acuity on three or more lines on the Snellen chart) was significantly higher in the GKRS group (60%) compared to the IBT group (44%) (p = 0.048). Local control, metastasis, and 5-year overall survival rates were statistically similar in both groups. CONCLUSIONS: GKRS can be preferred as an eye-sparing treatment option for posterior uveal melanoma in cases where brachytherapy cannot be used.
PURPOSE: To compare the efficacies of iodine-125 brachytherapy (IBT) and gamma knife stereotactic radiosurgery (GKRS) in the treatment of posterior uveal melanoma. METHODS: The demographic data and tumor characteristics at diagnosis of 201 patients treated with IBT and 52 patients treated with GKRS were recorded. The two treatments were then compared in terms of complications, local control, eye retention, metastasis, and overall survival rate. RESULTS: The median follow-up time was 56 months for the GKRS group and 45 months for the IBT group (p = 0.167). There were no significant differences in demographic data or tumor characteristics between the groups at diagnosis. Radiation retinopathy, radiation optic neuropathy, and neovascular glaucoma occurred at similar rates in both groups. However, radiation maculopathy and cataracts occurred more frequently in the GKRS group. The number of cases that have developed vision loss (worsening of best-corrected visual acuity on three or more lines on the Snellen chart) was significantly higher in the GKRS group (60%) compared to the IBT group (44%) (p = 0.048). Local control, metastasis, and 5-year overall survival rates were statistically similar in both groups. CONCLUSIONS: GKRS can be preferred as an eye-sparing treatment option for posterior uveal melanoma in cases where brachytherapy cannot be used.
Authors: Lee M Jampol; Claudia S Moy; Timothy G Murray; Sandra M Reynolds; Daniel M Albert; Andrew P Schachat; Kenneth R Diddie; Robert E Engstrom; Paul T Finger; Kenneth R Hovland; Leonard Joffe; Karl R Olsen; Craig G Wells Journal: Ophthalmology Date: 2002-12 Impact factor: 12.079
Authors: Achilles J Fakiris; Simon S Lo; Mark A Henderson; Thomas C Witt; Robert M Worth; Ronald P Danis; Paul M Des Rosiers; Robert D Timmerman Journal: Stereotact Funct Neurosurg Date: 2007-01-12 Impact factor: 1.875
Authors: Russell P Joye; Lloyd B Williams; Michael D Chan; Andre J Witkin; Clemens M Schirmer; John E Mignano; David E Wazer; Kevin C Yao; Julian K Wu; Jay S Duker Journal: Ophthalmic Surg Lasers Imaging Retina Date: 2014 Mar-Apr Impact factor: 1.300