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Radiation complications and tumor control after plaque radiotherapy of choroidal melanoma with macular involvement.
- Source :
-
American journal of ophthalmology [Am J Ophthalmol] 1999 May; Vol. 127 (5), pp. 579-89. - Publication Year :
- 1999
-
Abstract
- Purpose: To determine the outcome of plaque radiotherapy in the treatment of macular choroidal melanoma and to identify the risk factors associated with the development of radiation complications, tumor recurrence, and metastasis.<br />Methods: Chart analysis of 630 consecutive patients (630 eyes) with macular choroidal melanoma managed by plaque radiotherapy between July 1976 and June 1992.<br />Results: The median largest basal tumor diameter was 10 mm, and the median tumor thickness was 4 mm. By means of Kaplan-Meier estimates, visually significant maculopathy developed at 5 years in 40% of the patients, cataract in 32%, papillopathy in 13%, and tumor recurrence in 9%. Vision decrease by 3 or more Snellen lines was found in 40% of the patients at 5 years. Sixty-nine eyes (11%) were enucleated because of radiation complications and recurrence. Twelve percent of the patients developed metastasis by 5 years and 22% by 10 years. Results of multivariate Cox proportional hazards analyses showed that the significant predictors for tumor recurrence were a distance of tumor margin from the optic disk of less than 2 mm (P = .003) and retinal invasion (P = .009). The significant variables that were predictive of metastasis included tumor thickness greater than 4 mm (P = .02) and largest basal tumor diameter greater than 10 mm (P = .03).<br />Conclusions: Plaque radiotherapy offers a 91% 5-year local tumor control rate for macular choroidal melanoma. Despite good local tumor control, the risk for metastasis is 12% at 5 years and 22% at 10 years. In 11% of the patients, enucleation eventually became necessary because of radiation complications and tumor recurrence.
- Subjects :
- Adult
Aged
Aged, 80 and over
Choroid Neoplasms mortality
Choroid Neoplasms pathology
Eye Diseases etiology
Eye Enucleation
Female
Humans
Male
Melanoma mortality
Melanoma pathology
Middle Aged
Neoplasm Invasiveness
Neoplasm Metastasis
Neoplasm Recurrence, Local
Proportional Hazards Models
Retinal Neoplasms mortality
Retinal Neoplasms pathology
Risk Factors
Visual Acuity
Brachytherapy adverse effects
Choroid Neoplasms radiotherapy
Eye radiation effects
Melanoma radiotherapy
Radiation Injuries etiology
Retinal Neoplasms radiotherapy
Subjects
Details
- Language :
- English
- ISSN :
- 0002-9394
- Volume :
- 127
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- American journal of ophthalmology
- Publication Type :
- Academic Journal
- Accession number :
- 10334352
- Full Text :
- https://doi.org/10.1016/s0002-9394(98)00445-0