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- Title
Gamma Knife Stereotactic Radiosurgery for the Treatment of Primary and Metastatic Ocular Malignancies.
- Authors
Arnett, Andrea L.H.; Reynolds, Margaret M.; Pulido, Jose S.; Parney, Ian F.; Laack, Nadia N.
- Abstract
<bold><italic>Background:</italic></bold> Gamma knife radiosurgery (GKR) can be used for precise targeting of malignant lesions of the CNS when brachytherapy is not an appropriate option. <bold><italic>Objectives:</italic></bold> This study reports treatment technique, efficacy, and radiation-induced adverse effects in patients with primary and metastatic ocular lesions treated with Leksell GKR. <bold><italic>Methods:</italic></bold> A retrospective, single-institution review was conducted of 28 patients with primary or metastatic ocular disease, treated from 2000 to 2014. The dose to margin was 17-27 Gy (maximum dose 28-54 Gy). Primary outcomes included overall survival (OS), local control, progression-free survival (PFS), and enucleation. <bold><italic>Results:</italic></bold> The median age at diagnosis was 70 years, and the median follow-up was 26.4 months. Of the 28 patients, 11 (39%) had metastatic ocular disease, and 17 (61%) were diagnosed with primary ocular melanoma (stage T2a-T4e). The average maximum dose and dose to margin were 41 and 21 Gy, respectively. The mean dose to the optic nerve was 12.6 Gy. The 5-year OS was 46% (95% CI: 23.6-68.4%) for the entire cohort; the 5-year PFS for M0 patients who presented with primary ocular melanoma lesions was 90% (95% CI: 71-100%). Only 1 patient required enucleation after radiation treatment. <bold><italic>Conclusion:</italic></bold> GKR is an effective option, with acceptable levels of toxicity, in the treatment of primary and metastatic ocular lesions.
- Publication
Stereotactic & Functional Neurosurgery, 2018, Vol 95, Issue 6, p363
- ISSN
1011-6125
- Publication type
Article
- DOI
10.1159/000478271