Journal article
Plaque Radiotherapy for Juxtapapillary Choroidal Melanoma Overhanging the Optic Disc in 141 Consecutive Patients
Archives of ophthalmology (1960), v 126(11), pp 1515-1522
01 Nov 2008
PMID: 19001218
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Objective: To evaluate tumor control with plaque radiotherapy for juxtapapillary choroidal melanoma that overhangs the optic disc.
Methods: Retrospective medical record review of 141 consecutive patients with data on complications of treatment, final visual acuity, visual loss, enucleation, tumor recurrence, metastasis, and death.
Results: The median patient age was 61 years. Presenting symptoms included reduced visual acuity in 72 eyes (51%), photopsia in 14 (10%), and visual field defect in 18 (13%); 35 patients (25%) were asymptomatic. The median tumor basal diameter was 11 mm and the median thickness was 5.2 mm. The tumor overhung 50% or less of the disc in 88 eyes (62%) and more than 50% of the disc in 53 eyes (38%). In 19 cases (13%), the tumor overhung the entire disc. All patients were treated with plaque radiotherapy, using a notched design in 126 eyes (89%) and a round design in 14 eyes (10%), with iodine 125 in 132 eyes (94%) and cobalt 60 in 9 eyes (6%). The median radiation dose to the tumor apex was 8500 cGy. Adjuvant transpupillary thermotherapy was used in 54 eyes (39%). During a mean follow-up of 56 months, complications included nonproliferative retinopathy in 61 eyes (51%), proliferative retinopathy in 26 (22%), maculopathy in 44 (37%), papillopathy in 57 (48%), neovascular glaucoma in 23 (19%), and vitreous hemorrhage in 48 (40%). A final visual acuity of 20/200 or worse was measured in 72 eyes (77%), and visual loss of more than 5 Snellen lines occurred in 59 eyes (63%). Enucleation was necessary in 27 eyes (23%). Tumor recurrence was found in 12 eyes (10%). Metastasis developed in 15 patients (13%) and death in 4 cases (3%).
Conclusions: Using plaque radiotherapy for choroidal melanoma overhanging the optic disc, local tumor control was achieved in 90% of cases. Tumor and radiation effects led to poor visual acuity in 77% of eyes. The metastatic rate was 13% and the mortality rate was 3%.
Metrics
Details
- Title
- Plaque Radiotherapy for Juxtapapillary Choroidal Melanoma Overhanging the Optic Disc in 141 Consecutive Patients
- Creators
- Mandeep S. Sagoo - Wills Eye HospitalCarol L. Shields - Thomas Jefferson Univ, Wills Eye Inst, Ocular Oncol Serv, Philadelphia, PA 19107 USAArman Mashayekhi - Thomas Jefferson Univ, Wills Eye Inst, Ocular Oncol Serv, Philadelphia, PA 19107 USAJorge Freire - Drexel Univ, Hahnemann Hosp, Coll Med, Dept Radiat Oncol, Philadelphia, PA 19104 USAJacqueline Emrich - Drexel UniversityJay Reiff - Drexel UniversityLydia Komarnicky - Drexel Univ, Hahnemann Hosp, Coll Med, Dept Radiat Oncol, Philadelphia, PA 19104 USAJerry A. Shields - Thomas Jefferson Univ, Wills Eye Inst, Ocular Oncol Serv, Philadelphia, PA 19107 USA
- Publication Details
- Archives of ophthalmology (1960), v 126(11), pp 1515-1522
- Publisher
- Amer Medical Assoc
- Number of pages
- 8
- Grant note
- TFC Frost Trust Fulbright Fellowship in Cancer Research
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Radiation Oncology (and Nuclear Medicine); [Retired Faculty]
- Web of Science ID
- WOS:000260797300005
- Scopus ID
- 2-s2.0-55949137262
- Other Identifier
- 991019168892004721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Ophthalmology