Abstract

This study presents findings from a retrospective analysis of 168 patients with uveal melanoma treated by stereotactic radio surgery (SRS) at linear accelerator in Slovakia. One-day session radio surgery at LINAC accelerator is a effective treatment modality in patients with uveal melanoma. The median tumor volume at baseline was 0.3cm3 (with range from 0.05 to 2.6cm³). The therapeutic dose was 35.0Gy by 99% of DVH (dose volume histogram). Average overall survival after stereotactic irradiation was 96.4% at 1year, 92.3% at 2years, 82.7% at 5years, followed by relatively stable survival of 81.6% during the rest of follow-up (6-10years). Survival rates at 5-year interval and the rates of secondary enucleating due to complications after one-day session linear accelerator irradiation were comparable to those achieved with other irradiation techniques used for treatment uveal melanoma. Radiation complications can lead to visual acuity reduction or secondary enucleating. Radiation-induced optic neuropathy (RION) is a severe ocular complication developing in high-risk patients with uveal melanoma after SRS. We analysed association between the secondary enucleating and the presence of secondary glaucoma or hemophtalmus as well as of the radiation-induced optic neuropathy after SRS. Secondary glaucoma led to secondary enucleating in 16.7% patients. The presence of optic neuropathy per se was significantly associated with a higher dose on the optic nerve (P=0.0123 in invariable and 0.0049 in multivariable analysis, respectively). Importantly, the overall survival of patients who underwent secondary enucleating was not different from the survival of patients without enucleating (P=0.7501).

Keywords

stereotactic radio surgery, radiation-induced optic neuropathy, glaucoma, computed tomography, magnetic resonance imaging, visual acuity, brachytherapy, proton beam radiotherapy,