LONG-TERM RESULTS OF COBALT-60 PLAQUE RAD IOTHERAPY IN THE TREATMENT OF UVEAL MELANOMAS

Purpose To analyze 65 patients with uveal melanomas treated with cobal t plaque therapy with regards to mortality, visual results and complic ations. Patients and methods Most of the melanomas were large (T3: 52. 5 %), with a mean largest dimension of the base of 11 mm, and a mean t hickness of 6 mm. Most of the tumors were located in the choroid (95 % ), with an anterior margin behind the equator (64 %), and a posterior margin at less than 3 mm of the disc and/or of the macula (69 %). The plaque radiotherapy delivered a mean dose of 95 Gy to the tumor apex, either with a cobalt plaque alone (51 cases), or in association with a ruthenium plaque (14 cases). The mean follow up period was over 8 yea rs. Results The local control was achieved initially in 86 % of the ey es. The estimated melanoma specific survival rate was 83 % after 5 yea rs and 74 % after 10 years. The main parameter associated with the met astases was the largest dimension of the base (p < 0.01). The eye was retained in 83 % of the cases. The probability of keeping a vision bet ter than or equal to 0,1 was 39 % after 5 years and 27 % after 10 year s. The main parameter associated with the visual loss was the tumor si ze (p < 0.01). The complications included cataract (39 %), radiation r etinopathy (34 %), with maculopathy (19 %) and/or papillopathy (13.5 % ), vitreous hemorrhages (22 %), neovascular glaucoma (15 %) and retina l detachment (12 %). Conclusion These results supported the value of c obalt plaque radiotherapy in the management of uveal melanomas.