Abstract
Purpose
To study local tumor control and radiogenic side-effects after fractionated stereotactic radiotherapy for uveal melanoma.
Patients and Methods
Between June 1997 and February 1998, 21 patients suffering from uveal melanomas have been treated with a stereotactic 6 MeV LINAC (Saturne 43®, General Electric, France) in conjunction with a stereotactic frame system (Brain LAB®, Germany). Immobilization of the eye was ensured with an optical fixation system which was proven reliable. During radiotherapy, movements of the irradiated eye were controlled on a monitor and documented by video recording. All patients co-operated very well with the optical fixation system. In 1164 measurements, the median value of horizontal deviation of the diseased eye during treatment was 0.3 mm (range: 0 to 1.3 mm). Median vertical deviation was 0.2 mm (range: 0 to 1.2 mm). For all patients, mean tumor prominence before treatment was 6.0±2.2 mm. In 20 patients, the total dose of 70 Gy (at 80%) was delivered in 5 fractions within 10 days. In one patient with a ciliary body tumor, the total dose of 70 Gy was divided into 7 fractions for better sparing of the anterior eye segment.
Results
After a follow-up of at least 6 months, local tumor control was seen in all eyes. Mean tumor thickness reduction after 3, 6 and 9 months was 7%, 13% and 31%, respectively. Up to now, only mild subacute side-effects located in the anterior eye segment have been noticed.
Conclusion
Optical fixation of the eye allows high precision stereotactic radiotherapy with small safety margins. Fractionated stereotactic radiotherapy and 70 Gy total dose delivered in 5 fractions seems to be appropriate for local tumor control in uveal melanoma. Further long-term studies with extended number of patients will be necessary to conclude on the use of linac-based fractionated stereotactic radiotherapy for uveal melanoma.
Similar content being viewed by others
References
Chinela AB, Zambrano A, Bunge HJ, et al. Gamma knife radiosurgery in uveal melanomas. In: Steiner L, Ed. Radiosurgery: baseline and trends. New York: Raven Press, 1992: 161–9.
Langmann G, Pendl G, Schröttner O, et al. Die radiochirugische Therapie mit der Leksell Gamma Einheit in der Behandlung von Aderhautmelanomen. Ein erster Erfahrungsbericht. Spektrum Augenheilk 1995; 9: 16–21.
Marchini G, Babighian S, Tomazzoli L, et al. Stereotactic radiosurgery of uveal melanomas: preliminary results with gamma knife treatment. Stereotact Funct Neurosurg 1995; 64(suppl. 1): 72–9.
Rand RW, Khonsary A, Brown WJ, et al. Leksell stereotactic radiosurgery in the treatment of eye melanoma. Neurological Research 1987; 9: 142–6.
Rennie I, Forster D, Kemeny A, et al. The use of single fraction Leksell stereotactic radiosurgery in the treatment of uveal melanoma. Acta Ophthalmol Scand 1996; 74: 558–62.
Zehetmayer M, Menapace R, Kitz K, et al. Steretoactic irradiation of uveal melanoma with the Leksell gamma unit. In: Wiegel T, Bornfeld N, Foerster MH, Hinkelbein W, Eds. Radiotherapy of Ocular Disease. Front Radiat Ther Oncol Basel: Karger, 1997; 165–71.
Zehetmayer M, Menapace R, Kitz K, et al. Stereotactic radiosurgery for uveal melanoma. In: Kogelnik HD, Ed. Progress in Radio-Oncology 5, Bologna: Monduzzi Editore, 1995; 451–4.
Tokuuye K, Yasukuki A, Sumi M, et al. Fractionated stereotactic radiotherapy for choroidal melanoma. Radiother Oncol 1997; 43: 87–91.
Debus J, Engenhart-Cabillic R, Holz FG, et al. Stereotactic Radiotherapy in the treatment of intraocular malignancies with a micro-multilcaf collimator. In: Wiegel T, Bornfeld N, Foerster MH, Hinkelbein W, Eds. Radiotherapy of Ocular Disease. Front Radiat Ther Oncol. Basel: Karger, 1997: 39–46.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Zehetmayer, M., Dieckmann, K., Kren, G. et al. Fractionated stereotactic radiotherapy with linear accelerator for uveal melanoma — Preliminary vienna results. Strahlenther Onkol 175 (Suppl 2), 74–75 (1999). https://doi.org/10.1007/BF03038894
Issue Date:
DOI: https://doi.org/10.1007/BF03038894