Stereotactic Radiosurgery Outcomes in Uveal Melanoma Patients: A 3-year Retrospective Study

To evaluate the three-year survival rate, local tumor control rate and complications of stereotactic radiosurgery in patients with uveal melanoma and compare the outcomes with the available literature.

In this study, data were evaluated from 122 patients treated for uveal melanoma, of whom 33 met the inclusion criteria for retrospective analysis of stereotactic radiosurgery outcomes using the CyberKnife system. These patients received radiotherapy for uveal melanoma during the period of 2016-2021. The data were collected during regular follow-up visits consisting of best-corrected visual acuity assessment, slit-lamp examination, indirect ophthalmoscopy, intraocular pressure measurement and ultrasound measurement of tumor prominence. As part of the metastases screening, abdominal ultrasound, chest X-ray, and magnetic resonance imaging (MRI) of the brain and orbits were performed regularly, with additional positron emission tomography (PET) combined with MRI performed as required.

In our cohort, the three-year eye preservation rate was 72.7%, while the three-year local tumor control reached the level of 75.8%. The three-year survival was 81.8%. Overall, metastases were detected in 30.3% of patients with the liver being affected in 44% of cases, the bones in 28%, and the lungs in 17%. The most common ocular complications of radiotherapy included cataracts (58.3% of phakic patients), neovascular glaucoma (39.4%), radiation maculopathy (27.3%) and radiation retinopathy (18.2%).

Stereotactic radiosurgery is a safe treatment method for uveal melanoma with the potential for eye preservation. However, it carries the risk of tumor recurrence and ocular complications. Three-year survival and the incidence of ocular complications in our study were consistent with the data reported in the literature. By contrast, three-year local tumor control reached lower values compared to the relevant studies. Some results may be limited due to the small number of subjects in our cohort.