Radiation complication and tumor control after plaque radiotherapy of choroidal melanoma with macular involvement Original Reearch Article

PURPOE: To determine the outcome of plaque radiotherapy in the treatment of macular choroidal melanoma and to identify the rik factor aociated with the development of radiation complication, tumor recurrence, and metatai. METHOD: Chart analyi of 630 conecutive patient (630 eye) with macular choroidal melanoma managed by plaque radiotherapy between July 1976 and June 1992. REULT: The median larget baal tumor diameter wa 10 mm, and the median tumor thickne wa 4 mm. By mean of Kaplan-Meier etimate, viually ignificant maculopathy developed at 5 year in 40% of the patient, cataract in 32%, papillopathy in 13%, and tumor recurrence in 9%. Viion decreae by 3 or more nellen line wa found in 40% of the patient at 5 year. ixty-nine eye (11%) were enucleated becaue of radiation complication and recurrence. Twelve percent of the patient developed metatai by 5 year and 22% by 10 year. Reult of multivariate Cox proportional hazard analye howed that the ignificant predictor for tumor recurrence were a ditance of tumor margin from the optic dik of le than 2 mm (P = .003) and retinal invaion (P = .009). The ignificant variable that were predictive of metatai included tumor thickne greater than 4 mm (P = .02) and larget baal tumor diameter greater than 10 mm (P = .03). CONCLUION: Plaque radiotherapy offer a 91% 5-year local tumor control rate for macular choroidal melanoma. Depite good local tumor control, the rik for metatai i 12% at 5 year and 22% at 10 year. In 11% of the patient, enucleation eventually became neceary becaue of radiation complication and tumor recurrence.