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Related Experiment Video

Updated: Nov 21, 2025

Implantation and Evaluation of Melanoma in the Murine Choroid via Optical Coherence Tomography
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Optimizing radiosurgery with photons for ocular melanoma.

I Frank Ciernik1,2, Markus Wösle1, Lothar Krause3

  • 1Department of Radiotherapy and Radiation Oncology, Dessau City Hospital, Dessau, Germany.

Physics and Imaging in Radiation Oncology
|January 18, 2021
PubMed
Summary

Dynamic conformal arcs with intensity-modulated fields (DCA-IMRT) offer superior ocular melanoma treatment planning compared to automated volumetric modulated arc therapy (VMAT). DCA-IMRT provides better planning target volume coverage and lower ocular doses, establishing it as the gold standard for fractionated stereotactic radiosurgery.

Keywords:
Automated planningChoroidal melanomaHybridArcIMRTMelanomaOcular melanomaRadiosurgerySBRTStereotacticUveal melanomaVMAT

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Area of Science:

  • Radiation Oncology
  • Medical Physics
  • Ophthalmology

Background:

  • Photon radiotherapy is an established treatment for ocular melanoma (OM).
  • Investigating novel planning techniques is crucial for optimizing OM treatment.
  • Fractionated stereotactic radiosurgery (fSRS) is utilized for OM.

Purpose of the Study:

  • To compare the planning qualities of two distinct radiotherapy approaches for ocular melanoma.
  • To evaluate a combination of dynamic conformal arcs (DCA) with intensity-modulated radiation therapy (IMRT) fields (DCA-IMRT).
  • To assess volumetric modulated arc therapy (VMAT) combined with automated planning (AP).

Main Methods:

  • Analysis of 13 ocular melanoma patients treated with DCA-IMRT using 50 Gy in 5 fractions.
  • Comparison of DCA-IMRT plans with automated planning (AP) VMAT plans derived from 28 prior DCA-IMRT cases.
  • Dose-volume constraints were used to generate the AP model for VMAT.

Main Results:

  • DCA-IMRT demonstrated superior plan quality over AP VMAT.
  • Median PTV coverage >95% was higher with DCA-IMRT (98.3%) than VMAT (95.1%).
  • DCA-IMRT resulted in lower median ocular dose (22.4 Gy vs 27.2 Gy) and lens dose compared to VMAT.

Conclusions:

  • The combination of DCA and IMRT fields is the gold standard for fSRS in ocular melanoma.
  • DCA-IMRT offers superior PTV coverage and organ-at-risk sparing, particularly for the lens.
  • This approach optimizes photon therapy for ocular melanoma treatment.