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Middle East African Journal of Ophthalmology Middle East African Journal of Ophthalmology
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Year : 2015  |  Volume : 22  |  Issue : 1  |  Page : 103-107

Regression rate of posterior uveal melanomas following iodine-125 plaque radiotherapy

1 Department of Ophthalmology and Visual Sciences, W.K. Kellogg Eye Center, Michigan, USA
2 Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, USA
3 Department of Ophthalmology and Visual Sciences, W.K. Kellogg Eye Center, Michigan; Department of Epidemiology, School of Public Health, Michigan, USA

Correspondence Address:
Hakan Demirci
W.K. Kellogg Eye Center, 1000 Wall Street, Ann Arbor, Michigan, 48105
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0974-9233.148358

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Aim: To characterize the regression rate of posterior uveal melanoma following radioactive iodine-125 (I-125) plaque. Materials and Methods: We retrospectively analyzed 95 patients with posterior uveal melanoma who were treated with only radioactive I-125 plaque and had more than 3 years follow-up. All patients were treated with plaque radiotherapy using tumor dose of 85 Gy at the tumor apex, following COMS protocol. Regression rate was assessed with standardized A-scan ultrasonography. Associations with tumor regression were evaluated by means of mixed linear regression modeling. Results: Mean decrease in the tumor thickness (% original thickness) at 12, 24, and 36 months after radiotherapy for melanomas <3 mm in thickness was 29%, 38%, and 45%, for melanoma 3-8 mm in thickness was 32%, 44%, and 59%, and for melanoma more than 8 mm in thickness was 52%, 62%, and 68%, respectively. With a doubling of follow-up time (0.5-1 year, or 1-2 years of follow-up from treatment), tumors <3 mm in thickness at treatment showed a 0.5 mm decrease in tumor thickness, whereas melanomas 3-8 mm showed a 1 mm decrease, and melanomas >8 mm showed a 1.7 mm decrease. Uveal melanomas that developed systemic metastasis showed an additional 0.4 mm decrease with a doubling of follow-up time from treatment, compared with those that did not develop metastasis (P = 0.050). Conclusions: Posterior uveal melanomas with higher initial thickness show steeper and more reduction in tumor thickness following radioactive I-125 plaque. After the initial phases, the regression curve became similar for tumors with different thicknesses.

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