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Relative survival rates and presence of complications in uveal melanoma patients after stereotactic radio surgery

Advances in Ophthalmology & Visual System
Alena Furdova,1 Iveta Waczulikova,2 Miron Sramka,3 Gabriel Kralik,3,4 Pavlina Zahorjanova,1 Karolina Kapitanova1
Department of Ophthalmology, Comenius University, Slovak Republic
Iveta Waczulikova, 1Department of Ophthalmology, Comenius University, Slovak Republic
Miron Sramka, Department of Nuclear Physics and Biophysics, Comenius University, Bratislava, Slovak Republic
Gabriel Kralik, Department of Medical Physics, Slovak Medical University, Slovak Republic
Pavlina Zahorjanova, Department of Ophthalmology, Comenius University, Slovak Republic
Karolina Kapitanova, Department of Ophthalmology, Comenius University, Slovak Republic


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).


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