Plaque radiotherapy for management of ciliary body and choroidal melanoma with extraocular extenion

PURPOE: To report the reult of plaque radiotherapy of ciliary body and choroidal melanoma with extraocular extenion. METHOD: Thi retropective tudy of 17 eye of 17 patient with ciliary body and choroidal melanoma demontrated extraocular extenion that wa clinically evident but le than 3 mm in thickne. In 14 eye, the extraocular extenion wa located anteriorly and in three poteriorly. The outcome of plaque radiotherapy in term of intraocular and extraocular tumor repone and the development of metatai were analyzed. REULT: At a median follow-up of 63 month (range, 23 to 164 month) after plaque radiotherapy, all patient howed control of both the intraocular and extraocular component of ciliary body and choroidal melanoma. In no cae did the intraocular or extraocular portion of the tumor relape. The initial median thickne of the intraocular component wa 4.9 mm, and the final median thickne wa 2.4 mm. The initial median thickne of the extraocular component wa 2.0 mm, and the final median thickne wa 1.0 mm. The initial median baal diameter of the extraocular component wa 3.5 mm, and the final median baal diameter wa 2.0 mm. Of 17 patient, 11 (10 with anterior and one with poterior extraocular extenion) howed partial regreion in bae and thickne of the extraocular extenion, and in ix there wa little or no change. In thoe with anterior extracleral extenion, the clera remained intact without clinically obervable necroi, and the cleral fiber were gradually more viible a the tumor regreed. Three patient (18%) died of metatatic melanoma at a median interval of 38 month after plaque radiotherapy. CONCLUION: Plaque radiotherapy appear to be a reaonable treatment option for elected cae of ciliary body and choroidal melanoma with clinically viible extraocular extenion le than 3 mm in thickne.