«GAMMA-KNIFE» STEREOTACTIC RADIOSURGERY FOR LARGE UVEAL MELANOMA AS AN ALTERNATIVE FOR ENUCLEATION (FIRST RESULTS)

Abstract

Development of stereotactic radiosurgery in ophthalmology started in the 1980s. Positive results in the Gamma-knife application were achieved in treatment of large uveal melanomas as an alternative for enucleation. The experience of Gamma-knife application inRussiais minimal.Purpose. To present the earliest results of treatment of patients with large uveal melanomas using the Gamma-knife radiosurgery.Material and methods. The study includes 7 patients with uveal melanoma (Т2-3N0M0) treated from June 2012 to December2013. Inall cases stereotactic radiosurgery was an alternative of eye enucleation and in 6 cases was a primary treatment. Irradiation was conducted according to the traditional planning technique irradiation with a 35-40 Gy by 50% isodose with maximum in tumor of 70-80 Gy. Follow-up was 2-18 months and in out-patients conditions.Results. The eyes and vision were preserved in 6 cases out of 7. Mean tumor regression was 2.8mm within more than 1 year. The main complication was radiation retinopathy of various manifestation.Conclusions. Gamma-knife radiosurgery allows to preserve the eyes with large uveal melanoma. Degree of radiogenic complications is not fatal for the eye. Nevertheless, a further follow-up is required for the treated patients to study possibilities of the method.

Keywords

• gamma-knife
• stereotactic radiosurgery
• uveal melanoma
• eye enucleation