Stereotactic radiosurgery of large uveal melanomas with the gamma-knife

• Published in: Ophthalmology (Rochester, Minn.) Vol. 107; no. 7; p. 1381
• Main Authors: Mueller, A J, Talies, S, Schaller, U C, Horstmann, G, Wowra, B, Kampik, A
• Format: Journal Article
• Language: English
• Published: United States 01-07-2000
• Subjects: Adult; Aged; Aged, 80 and over; Female; Humans; Magnetic Resonance Imaging; Male; Melanoma - diagnosis; Melanoma - surgery; Middle Aged; Orbit - pathology; Prospective Studies; Radiosurgery - methods; Treatment Outcome; Uveal Neoplasms - diagnosis; Uveal Neoplasms - surgery; Visual Acuity
• ISSN: 0161-6420
• DOI: 10.1016/S0161-6420(00)00150-0

To present our experience with the Gamma-knife in treating large uveal melanomas with stereotactic radiosurgery.
Prospective, noncomparative, interventional case series.
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.
Stereotactic radiosurgery with the Gamma-knife.
Tumor control, maximum apical tumor height, eye retention rate, and visual acuity.
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).
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.