Stereotactic Radiosurgery for Medium and Large Uveal Melanoma with a Non-Invasive Eye Immobilization Device, a Single Institutional Case Series.

Purpose: To investigate the treatment outcome, visual outcome, and adverse effects of five-fraction stereotactic radiosurgery (SRS) to medium-and large-sized uveal melanoma with a non-invasive eye immobilization device.Methods: Medical records of 14 patients with uveal melanoma receiving SRS with a total dose of 50 Gy in five fractions from 2008 to 2017 were retrospectively reviewed. A non-invasive eye fixation device was used to achieve and monitor eye immobilization.Results: Local tumor control rates were 85.7% and 75.0% at 2 and 5 years, respectively. The average tumor diameter decreased significantly from 10.0 +/- 3.21 mm to 8.36 +/- 3.71 mm (p = 0.038) 15 months after SRS, while the average tumor thickness decreased significantly from 5.45 +/- 2.21 mm to 4.34 +/- 2.29 (p = 0.036) 21 months after SRS. The 5-year metastasis-free survival was 87.5%. The mean best-corrected visual acuity (BCVA) deteriorated from logMAR 0.296 at baseline to logMAR 1.112 at the last individual follow-up visits (p < 0.001). Adverse effects of SRS were comparable to those reported with proton-beam radiotherapy or Gamma knife therapy.Conclusion: SRS combined with a non-invasive eye immobilization device is an effective and safe alternative eye-preserving treatment for medium-to large-sized uveal melanoma. BCVA at 3 months may be a predictor for BCVA at 1 year.Copyright (c) 2023, Formosan Medical Association. Published by Elsevier Taiwan LLC. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).