Preliminary experience in the treatment of choroidal melanoma with gamma knife radiosurgery

R. Woodbourn, R. Danis, R. Timmerman, T. Witt, T. Ciulla, R. Worth, M. Bank, S. Coffman

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Object. The authors report their early results from an ongoing experience treating patients with choroidal melanoma by using gamma knife radiosurgery (GKS). Methods. Between September 1998 and March 2000, 11 patients were treated for choroidal melanoma. Treatment was facilitated with specialized frame placement. Eye immobilization was accomplished with supra- and infraorbital nerve block and tethering sutures to the periorbital tissue. Magnetic resonance imaging was performed to localize the tumor for treatment planning. Plugging patterns were used to steer fall-off radiation away from the fovea, optic nerve, or lens. Tumor volume, tumor location relative to critical structures, and dose to critical structures were determined using GammaPlan. Tumor response was determined using ultrasonography. Toxicity was determined by clinical assessment, visual acuity testing, and ophthalmoscopy. All 11 patients successfully completed the treatment. In every case, 40 Gy was prescribed to the 50% isodose, which completely encompassed all visible tumor. Tumor height ranged from 2.9 to 7 mm. The tumor diameter ranged from 6 to 13 mm. The range of follow up was 2 to 19 months. No tumor has progressed. One patient had improvement in vision because of improvement in retinal detachment. Two patients experienced visual decline. One patient's visual decline was due to a vitreous hemorrhage, and the other's was due to hard exudates encroaching on the macula. One patient has developed a dry eye that is managed effectively with topical eye lubricants. Conclusions. This preliminary experience demonstrates that GKS is a feasible treatment option for small- to medium-sized choroidal melanomas. Longer follow up and additional patients will be required to improve the assessment and the ultimate tumor control and toxicity in this ongoing series.

Original languageEnglish (US)
Pages (from-to)177-179
Number of pages3
JournalJournal of Neurosurgery
Volume93
Issue numberSUPPL. 3
StatePublished - 2000

Fingerprint

Radiosurgery
Melanoma
Neoplasms
Therapeutics
Vitreous Hemorrhage
Lubricants
Ophthalmoscopy
Nerve Block
Retinal Detachment
Exudates and Transudates
Optic Nerve
Tumor Burden
Immobilization
Sutures
Lenses
Visual Acuity
Ultrasonography
Magnetic Resonance Imaging
Radiation

Keywords

  • Choroidal melanoma
  • Gamma knife radiosurgery
  • Melanoma
  • Ocular melanoma
  • Uveal melanoma

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

Cite this

Woodbourn, R., Danis, R., Timmerman, R., Witt, T., Ciulla, T., Worth, R., ... Coffman, S. (2000). Preliminary experience in the treatment of choroidal melanoma with gamma knife radiosurgery. Journal of Neurosurgery, 93(SUPPL. 3), 177-179.

Preliminary experience in the treatment of choroidal melanoma with gamma knife radiosurgery. / Woodbourn, R.; Danis, R.; Timmerman, R.; Witt, T.; Ciulla, T.; Worth, R.; Bank, M.; Coffman, S.

In: Journal of Neurosurgery, Vol. 93, No. SUPPL. 3, 2000, p. 177-179.

Research output: Contribution to journalArticle

Woodbourn, R, Danis, R, Timmerman, R, Witt, T, Ciulla, T, Worth, R, Bank, M & Coffman, S 2000, 'Preliminary experience in the treatment of choroidal melanoma with gamma knife radiosurgery', Journal of Neurosurgery, vol. 93, no. SUPPL. 3, pp. 177-179.
Woodbourn R, Danis R, Timmerman R, Witt T, Ciulla T, Worth R et al. Preliminary experience in the treatment of choroidal melanoma with gamma knife radiosurgery. Journal of Neurosurgery. 2000;93(SUPPL. 3):177-179.
Woodbourn, R. ; Danis, R. ; Timmerman, R. ; Witt, T. ; Ciulla, T. ; Worth, R. ; Bank, M. ; Coffman, S. / Preliminary experience in the treatment of choroidal melanoma with gamma knife radiosurgery. In: Journal of Neurosurgery. 2000 ; Vol. 93, No. SUPPL. 3. pp. 177-179.
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