UVEAL MELANOMA

Intraocular melanoma is the most commun primary ocular malignancy in W hites. Epidemiologic studies demonstrated the role of sun exposure as a risk for uveal melanoma. Conservative treatment techniques are indic ated for localised tumors when feasible. External radiation therapy an d radioactive eye plaque brachytherapy seem as effective as surgery in term of survival. High tumor doses can be safely administred with eit her helium or proton beams. A partial preservation of the vision is po ssible in most of patients. However, even for locally controlled patie nts, distant metastases can occur. Liver is the most frequent metasiat ic site, and also the first involved. Liver metastases are associated with a low response rate, to dacarbazine and nitrousourea. Recent stud ies using a new nitrousourea, fotemustine, administred locally through an intra-arterial catether, show that it produces encouraging results with a good hepatic and hematologic tolerance.