10-YEAR FOLLOW-UP OF HELIUM ION THERAPY FOR UVEAL MELANOMA

PURPOSE: To examine the results of helium ion irradiation in 218 patie nts with uveal melanoma treated more than 10 years ago. METHOD: A retr ospective review was made of 218 patients (218 eyes) treated with heli um ion radiation for uveal melanoma between 1978 and 1984. RESULTS: Af ter helium ion irradiation, 208 (95.4%) of 218 eyes had local tumor co ntrol. Ten years after irradiation, 46 (22.4%) of 218 eyes had been en ucleated; the majority of enucleations (37 of 46) resulted from anteri or ocular segment complications. Ten years after radiation, 102 (46.8% ) of the 218 patients were dead; 51 had non-melanoma-related deaths an d 51 had died of metastatic melanoma. Best-corrected visual acuity aft er radiation was greater than 20/40 in 21 (23%) of 93 eyes of the pati ents who were alive and who had retained their eyes 10 or more years a fter treatment. In patients with tumors less than 6 mm in height and m ore than 3 mm distant from the nerve or the fovea, 13 (72%) of 18 reta ined visual acuity greater than 20/40. In contrast, only 11% of the pa tients with either thicker tumors or those close to the nerve or fovea retained that level of visual acuity. CONCLUSIONS: Helium ion irradia tion of uveal melanoma is associated with good local tumor control and reasonable retention of the treated eye 10 years after treatment. In eyes with tumors less than 6 mm in thickness and more than 3 mm distan t from the optic nerve and fovea, many retain excellent vision.