Gamma knife radiosurgery in ophthalmic oncology

Background The aim of this retrospective study was to present the results of visual acuity, complications, adjuvant therapy, local tumor control rate and eye preservation after gamma knife radiosurgery (GKR) of uveal melanoma. Material and methods The disease histories of all patients treated by GKR between June 1992 and Mai 2010 & x202f;at the Department of Ophthalmology, University Hospital Graz for uveal melanoma were analyzed. The initial best corrected visual acuity, the timing of visual deterioration, patient, tumor and treatment parameters, complications and adjuvant therapies were collated and analyzed using descriptive statistics. The follow-up observational period ended in December 2018. Results A total of 189 patients were treated with the Leksell gamma knife within the defined timeframe. Of the patients 177 could be included in this study. The mean follow-up time was 51.9 months. Of the patients 164 (92.6%) developed complications associated with GKR. In 100 (56.4%) patients 1 or more adjuvant treatments were necessary. Throughout the follow-up observational period a tumor control of 94.4% (167 patients) could be achieved. Recurrences occurred in 10 (5.6%) patients, 3.1-60.7 months after GKR. Metastases were detected in 21 (11.8%) patients within 5.3-136.2 months after GKR. Conclusion The GKR procedure is a promising treatment option for uveal melanoma providing a high tumor control rate. It is minimally invasive and no prior surgery is necessary. The treatment takes only a few hours and can be carried out in an outpatient setting. The physical characteristics of the gamma knife and the steep dose decay are well-suited for the treatment of uveal melanoma with its special radiobiological features.