Abstract
AIMS: To determine the long term visual outcome of patients who were eligible for randomisation to enucleation versus brachytherapy in a US collaborative ocular melanoma study (COMS) but were treated with either helium ion or 125I radioactive plaque therapy. METHOD: A retrospective analysis was performed of 426 ciliochoroidal melanomas that met COMS inclusion criteria for randomisation to enucleation versus radioactive plaque but were treated with either helium ions or 125I brachytherapy. RESULTS: At 3 years 36.0% of eyes had 6/12 or better visual acuity. The length of visual retention was most dependent on tumour thickness, tumour location with respect to the optic nerve, fovea, or ciliary body, and patient age. In addition to these factors, the retention of 6/12 visual acuity and the time to 6/120 visual acuity were dependent on the preoperative visual acuity. The risk of visual loss was greatest immediately after treatment and decreased with time. The 5 year actuarial metastatic rate was approximately 13%. Patients at the greatest risk of post-radiation visual loss had significantly greater risk of tumour related mortality. CONCLUSIONS: Some patients who would have been eligible for randomisation to either enucleation or radioactive plaque therapy can be irradiated with retention of excellent vision.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Adams K. S., Abramson D. H., Ellsworth R. M., Haik B. G., Bedford M., Packer S., Seddon J., Albert D., Polivogianis L. Cobalt plaque versus enucleation for uveal melanoma: comparison of survival rates. Br J Ophthalmol. 1988 Jul;72(7):494–497. doi: 10.1136/bjo.72.7.494. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Augsburger J. J., Gamel J. W., Sardi V. F., Greenberg R. A., Shields J. A., Brady L. W. Enucleation vs cobalt plaque radiotherapy for malignant melanomas of the choroid and ciliary body. Arch Ophthalmol. 1986 May;104(5):655–661. doi: 10.1001/archopht.1986.01050170045019. [DOI] [PubMed] [Google Scholar]
- Augsburger J. J., Goel S. D. Visual function following enucleation or episcleral plaque radiotherapy for posterior uveal melanoma. Arch Ophthalmol. 1994 Jun;112(6):786–789. doi: 10.1001/archopht.1994.01090180084039. [DOI] [PubMed] [Google Scholar]
- Butler P., Char D. H., Zarbin M., Kroll S. Natural history of indeterminate pigmented choroidal tumors. Ophthalmology. 1994 Apr;101(4):710–717. doi: 10.1016/s0161-6420(94)31274-7. [DOI] [PubMed] [Google Scholar]
- Caplan R. J., Pajak T. F., Cox J. D. Analysis of the probability and risk of cause-specific failure. Int J Radiat Oncol Biol Phys. 1994 Jul 30;29(5):1183–1186. doi: 10.1016/0360-3016(94)90416-2. [DOI] [PubMed] [Google Scholar]
- Char D. H., Castro J. R., Kroll S. M., Irvine A. R., Quivey J. M., Stone R. D. Five-year follow-up of helium ion therapy for uveal melanoma. Arch Ophthalmol. 1990 Feb;108(2):209–214. doi: 10.1001/archopht.1990.01070040061031. [DOI] [PubMed] [Google Scholar]
- Char D. H., Quivey J. M., Castro J. R., Kroll S., Phillips T. Helium ions versus iodine 125 brachytherapy in the management of uveal melanoma. A prospective, randomized, dynamically balanced trial. Ophthalmology. 1993 Oct;100(10):1547–1554. doi: 10.1016/s0161-6420(93)31446-6. [DOI] [PubMed] [Google Scholar]
- Char D. H., Stone R. D., Irvine A. R., Crawford J. B., Hilton G. F., Lonn L. I., Schwartz A. Diagnostic modalities in choroidal melanoma. Am J Ophthalmol. 1980 Feb;89(2):223–230. doi: 10.1016/0002-9394(80)90115-4. [DOI] [PubMed] [Google Scholar]
- De Potter P., Shields C. L., Shields J. A., Cater J. R., Tardio D. J. Impact of enucleation versus plaque radiotherapy in the management of juxtapapillary choroidal melanoma on patient survival. Br J Ophthalmol. 1994 Feb;78(2):109–114. doi: 10.1136/bjo.78.2.109. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Fine S. L. Do I take the eye out or leave it in? Arch Ophthalmol. 1986 May;104(5):653–654. doi: 10.1001/archopht.1986.01050170043018. [DOI] [PubMed] [Google Scholar]
- Gragoudas E. S., Seddon J. M., Egan K., Glynn R., Munzenrider J., Austin-Seymour M., Goitein M., Verhey L., Urie M., Koehler A. Long-term results of proton beam irradiated uveal melanomas. Ophthalmology. 1987 Apr;94(4):349–353. doi: 10.1016/s0161-6420(87)33456-6. [DOI] [PubMed] [Google Scholar]
- Hillis A., Maguire M., Hawkins B. S., Newhouse M. M. The Markov process as a general method for nonparametric analysis of right-censored medical data. J Chronic Dis. 1986;39(8):595–604. doi: 10.1016/0021-9681(86)90184-0. [DOI] [PubMed] [Google Scholar]
- Lommatzsch P. K. Results after beta-irradiation (106Ru/106Rh) of choroidal melanomas: 20 years' experience. Br J Ophthalmol. 1986 Nov;70(11):844–851. doi: 10.1136/bjo.70.11.844. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Meecham W. J., Char D. H., Kroll S., Castro J. R., Blakely E. A. Anterior segment complications after helium ion radiation therapy for uveal melanoma. Radiation cataract. Arch Ophthalmol. 1994 Feb;112(2):197–203. doi: 10.1001/archopht.1994.01090140073026. [DOI] [PubMed] [Google Scholar]
- Samuelsen S. O., Kongerud J. Interval censoring in longitudinal data of respiratory symptoms in aluminium potroom workers: a comparison of methods. Stat Med. 1994 Sep 15;13(17):1771–1780. doi: 10.1002/sim.4780131708. [DOI] [PubMed] [Google Scholar]
- Seddon J. M., Gragoudas E. S., Albert D. M., Hsieh C. C., Polivogianis L., Friedenberg G. R. Comparison of survival rates for patients with uveal melanoma after treatment with proton beam irradiation or enucleation. Am J Ophthalmol. 1985 Mar 15;99(3):282–290. doi: 10.1016/0002-9394(85)90357-5. [DOI] [PubMed] [Google Scholar]
- Seddon J. M., Gragoudas E. S., Polivogianis L., Hsieh C. C., Egan K. M., Goitein M., Verhey L., Munzenrider J., Austin-Seymour M., Urie M. Visual outcome after proton beam irradiation of uveal melanoma. Ophthalmology. 1986 May;93(5):666–674. doi: 10.1016/s0161-6420(86)33700-x. [DOI] [PubMed] [Google Scholar]
- Young L. H., Gragoudas E. S. Macular uveal melanoma treated with proton beam irradiation. 10-year follow-up observation with histopathologic correlation. Retina. 1994;14(1):43–46. [PubMed] [Google Scholar]