Maheshwari A, et al. - In this work, physicians presented their 12-year experience with low energy photon, slotted eye plaque radiation therapy for choroidal melanoma. A normalized plaque-tumor position was provided by slotted plaque radiation therapy; such that the entire choroidal melanoma plus a 2-3 mm free margin of normal-appearing tissue was included in the targeted zone. Slotted plaque radiation therapy resulted in high rates of local tumor control, vision and eye retention, at 12-years.

Methods

• Design of this study was retrospective interventional case series.
• The physicians performed this study at the New York Eye Cancer Center.
• They enrolled 52 consecutive patients with uveal melanomas near, touching or surrounding the optic disc.
• Intervention included slotted eye plaque radiation therapy.
• Main outcome measures were change in visual acuity, local tumor control, radiation side effects, eye salvage and systemic metastases.

Results

• In this study, tumors were peripapillary within 1.5-mm of the optic disc (n=8,15%), juxtapapillary touching ≤180 degrees (n=23,44%), or circumpapillary >180 and encircling the disc (n=21,41%).
• Mean follow-up was 47 months (median 34 months; range 6-146 months).
• A mean 41.2% reduction in tumor thickness was induced by radiation.
• In life table analysis, 69% patients were found to retain their visual acuities ≥20/40 and had a vision loss free survival 84 months after treatment.
• In addition, 90% patients retained their visual acuity between 20/50-20/200 and had a vision loss free survival 36 month after treatment.
• A correlation was noted between slotted plaque brachytherapy with 4% secondary cataract, 11% neovascular glaucoma, no dry eye or eyelash loss.
• In 98.1% patients, local tumor control (no recurrence) was achieved.
• An overall enucleation-free survival of 93% and metastasis-free survival of 94% was observed in life table analysis.