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High-compared with low-dose radiosurgery for uveal melanomas.

Gerald Langmann1, Gerhard Pendl, Klaus Müllner

  • 1Department of Ophthalmology, Karl-Franzens University, Graz, Austria. gerald.langmann@uni-graz.at

Journal of Neurosurgery
|January 1, 2003
PubMed
Summary

Lowering gamma knife radiosurgery doses for uveal melanoma (UM) achieved similar tumor regression rates. This high-dose vs. low-dose irradiation approach reduced severe complications like neovascular glaucoma.

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Area of Science:

  • Ophthalmology
  • Radiation Oncology
  • Oncology

Background:

  • Uveal melanoma (UM) is the most common primary intraocular malignancy.
  • Gamma knife radiosurgery (GKR) is a treatment option for UM.
  • Optimizing GKR dose is crucial for balancing efficacy and toxicity.

Purpose of the Study:

  • To compare the outcomes of high-dose versus low-dose GKR in patients with uveal melanoma.
  • To evaluate tumor regression rates and severe complications between the two dose groups.

Main Methods:

  • Retrospective comparison of 31 patients treated with high-dose (mean 52.1 Gy) and 33 patients with low-dose (mean 41.5 Gy) GKR for UM.
  • Technical procedure remained consistent, differing only in radiation dose.
  • Outcomes assessed included complete and partial tumor regression and incidence of neovascular glaucoma.

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Main Results:

  • Complete tumor regression was observed in 26% of the high-dose group versus 12% in the low-dose group.
  • Partial regression (50-80% reduction) was higher in the low-dose group (81%) compared to the high-dose group (58%).
  • Severe complication rates, specifically neovascular glaucoma, were significantly lower in the low-dose group (9%) than the high-dose group (48%).

Conclusions:

  • Reducing the GKR margin dose for UM from 52.1 Gy to 41.5 Gy appears to maintain comparable tumor regression rates.
  • Lowering the radiation dose significantly reduces the incidence of severe side effects, such as neovascular glaucoma.
  • A shorter follow-up period in the low-dose group necessitates further investigation.