Local Recurrence in Choroidal Melanomas following Robotic-Assisted Radiosurgery (CyberKnife).

Area of Science:

• Ophthalmology
• Radiation Oncology
• Medical Physics

Background:

• Choroidal melanoma recurrence impacts survival due to metastasis.
• Robotic-assisted radiosurgery (CyberKnife) is used for choroidal melanoma treatment.
• Identifying recurrence risk factors is crucial for improving patient outcomes.

Purpose of the Study:

• To identify risk factors for local recurrence and side effects after CyberKnife treatment for choroidal melanoma.
• To analyze tumor planning and treatment parameters associated with recurrence.

Main Methods:

• Retrospective review of 694 patients treated with CyberKnife (2005-2019).
• Analysis of patient demographics, tumor characteristics, treatment planning, and radiation doses.
• Recording of recurrence, salvage therapy, survival, metastasis, and complications.

Main Results:

• Local recurrence occurred in 74 patients (10.7%) at a mean of 42.1 months post-treatment.
• Risk factors for local recurrence included non-contrast MRI planning, radiation doses < 21 Gy, and inadequate margin delineation.
• Salvage therapy included enucleation (68.9%) and repeat radiosurgery (25.7%).

Conclusions:

• CyberKnife is a viable option for large choroidal melanomas (up to 12 mm).
• Factors like contrast MRI, adequate radiation dose, and precise margin delineation are key for local control.
• Repeat CyberKnife treatment as salvage therapy shows good eye retention rates (81%).