Journal Article

Local Control and Results of Leksell Gamma Knife Therapy for the Treatment of Uveal Melanoma

Wu, Julian K., Schirmer, Clemens M., Wazer, David E., Yao, Kevin C., Mignano, John E., Chan, Michael D., Williams, Lloyd B., Witkin, Andre J., Duker, Jay S., Joye, Russell P.

2014

Overview

To evaluate the effectiveness of Leksell Gamma Knife stereotactic radio-surgery (Elekta, Stockholm, Sweden) with respect to local tumor control, visual acuity, and radiation side effects for uveal melanoma. Retrospective, non-comparative case series of 23 patients with uveal melanoma treated with Gamma Knife stereotactic radiosurgery at Tufts Medical Center from 2000 to 2012. Patients received single-fraction stereotactic radiation therapy of 20-25 gray (Gy) (mean: 21.7 Gy), primarily at the 50% isodose line. Follow-up was 4 to 121 months (median: 41.5 months). Main outcome measures included local tumor control, metastasis, visual acuity, and complications of therapy. In 21 of 23 patients (91%), local control was achieved with a single session of Gamma Knife therapy. Both patients who did not have local control, as well as a third patient (three of 23, 13%) developed liver metastases. Visual acuity was 20/200 or better in eight of 23 patients (35%) at last follow-up. Radiation side effects severe enough to cause vision loss were present in 14 of 23 patients (61%). Gamma Knife therapy may be an effective alternative to enucleation in patients with uveal melanoma who are deemed less satisfactory candidates for brachytherapy or wish to avoid surgery.

• Publisher: SLACK INCORPORATED
• Subject: Adolescent / Adult / Aged / Aged, 80 and over / Eye surgery / Female / Humans / Laser surgery / Liver Neoplasms - secondary / Male / Melanoma / Melanoma - secondary / Melanoma - surgery / Middle Aged / Ophthalmology / Radiation Injuries - etiology / Radiosurgery - adverse effects / Radiosurgery - methods / Retina - radiation effects / Retrospective Studies / Treatment Outcome / Uveal Neoplasms - pathology / Uveal Neoplasms - surgery / Vision, Low - etiology / Visual Acuity - physiology