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Παρασκευή 17 Φεβρουαρίου 2017

Stereotactic Radiosurgery and Fractionated Stereotactic Radiotherapy for the Treatment of Uveal Melanoma

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Publication date: Available online 17 February 2017
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Gozde Yazici, Hayyam Kiratli, Gokhan Ozyigit, Sezin Yuce Sari, Mustafa Cengiz, Bercin Tarlan, Burce Ozgen Mocan, Faruk Zorlu
PurposeTo evaluate treatment results of stereotactic radiosurgery or fractionated stereotactic radiotherapy (SRS/FSRT) for uveal melanoma.Methods and MaterialsWe retrospectively evaluated 181 patients with 182 uveal melanomas receiving SRS/FSRT between 2007 and 2013. Treatment was administered via the CyberKnife® (Accuray Inc., Sunnyvale, CA, USA).ResultsAccording to Collaborative Ocular Melanoma Study criteria, tumor size was small in 1%, medium in 49.5%, and large in 49.5% of the patients. Seventy-one tumors received <45 Gy and 111 received ≥45 Gy. Median follow-up time was 24 months. Complete and partial response was observed in 8 and 104 eyes, respectively. The rate of 5-year overall survival (OS) was 98%, disease-free survival (DFS) 57%, local recurrence-free survival (LRFS) 73%, distant metastasis-free survival (DMFS) 69%, and enucleation-free survival (EFS) 73%. There was a significant correlation between tumor size and DFS, SRS/FSRT dose and EFS; and both were prognostic for LRFS. Enucleation was performed in 41 eyes due to progression in 26 and complications in 11.ConclusionsThe radiotherapy dose is of great importance for local control and eye retention; the best treatment outcome was achieved using ≥45 Gy in 3 fractions.

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The results of stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (FSRT) in uveal melanoma was retrospectively evaluated. It was found that with doses of ≥45 Gy in 3 fractions higher tumor control rates are achieved. Two-year EFS rate was 73% for all, and 69% for large tumors, respectively.


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