Stereotactic Radiosurgery and Fractionated Stereotactic Radiotherapy for the Treatment of Uveal Melanoma
Menée à partir de données portant sur 181 patients atteints d'un mélanome de l'uvée traité entre 2007 et 2013 (durée médiane de suivi : 24 mois), cette étude évalue, du point de vue du contrôle de la maladie, de la survie sans énucléation et du taux de survie globale à 5 ans, l'efficacité d'une radiochirurgie stéréotaxique et d'une radiothérapie stéréotaxique fractionnée en fonction de la dose de rayonnements administrée (inférieure à 45 Gy ou supérieure ou égale à 45 Gy)
Résumé en anglais
Purpose : To evaluate treatment results of stereotactic radiosurgery or fractionated stereotactic radiotherapy (SRS/FSRT) for uveal melanoma.
Methods and Materials : We retrospectively evaluated 181 patients with 182 uveal melanomas receiving SRS/FSRT between 2007 and 2013. Treatment was administered via the CyberKnife® (Accuray Inc., Sunnyvale, CA, USA).
Results : According to Collaborative Ocular Melanoma Study criteria, tumor size was small in 1%, medium in 49.5%, and large in 49.5% of the patients. Seventy-one tumors received <45 Gy and 111 received ≥45 Gy. Median follow-up time was 24 months. Complete and partial response was observed in 8 and 104 eyes, respectively. The rate of 5-year overall survival (OS) was 98%, disease-free survival (DFS) 57%, local recurrence-free survival (LRFS) 73%, distant metastasis-free survival (DMFS) 69%, and enucleation-free survival (EFS) 73%. There was a significant correlation between tumor size and DFS, SRS/FSRT dose and EFS; and both were prognostic for LRFS. Enucleation was performed in 41 eyes due to progression in 26 and complications in 11.
Conclusions : The radiotherapy dose is of great importance for local control and eye retention; the best treatment outcome was achieved using ≥45 Gy in 3 fractions.
