Linear Accelerator Stereotactic Radiosurgery in Intraocular Malignant Melanoma

Objective: Linear accelerator based stereotactic radiosurgery of intraocular malignant melanoma is a method to treat uveal melanoma (ciliary body and choroid). Material and Methods: Retrospective clinic-based study of patients with posterior uveal melanoma in stage T1 - T3 who underwent stereotactic radiosurgery at linear accelerator in period 2001- 2013. Results: In group of 123 patients with posterior uveal melanoma treated with one day session stereotactic radiosurgery the median tumor volume was 0.6 cm3 (0.2 - 1.0 cm3). Patient age ranged from 25 to 82 years with a median of 55 years. The therapeutic dose applied to melanoma was 35.0 Gy, median maximal dose applied was 49.0 Gy (37.0 - 54.0 Gy). In the group of small tumors the volume regression was verified in 6 months and 12 months interval after the therapy by ultrasound and MRI (there was no presence of increase of the elevation). In 24 months interval the tumor regression was present in 25 cases from 35 cases (71.4 %). Tumor local control was successful in 95 % of patients in 2 years interval after stereotactic radiosurgery and in 85 % of patients in 5 years interval after stereotactic radiosurgery. Secondary enucleation due secondary glaucoma was necessary in 14 patients (11.4 %) in 3 to 5 year interval after irradiation. Conclusion: One step LINAC based stereotactic radiosurgery with a single dose 35.0 Gy is treatment option to treat T1 to T3 stage intraocular melanoma.