Radiology, Vol 156, 801-803, Copyright © 1985 by Radiological Society of North America
Malignant melanoma of the eye: treatment of posterior uveal lesions by Co-60 plaque radiotherapy versus enucleation
AM Markoe, LW Brady Jr, JA Shields, JJ Augsburger, B Micaily, JI Damsker, JL Day and JW Gamel
Survival rates and visual acuity of 100 patients treated for posterior
uveal malignant melanoma by cobalt-60 plaque radiotherapy were compared
with 150 patients treated by enucleation for the same disease. Life- table
comparisons of the entire group showed significant differences in survival
rates, with plaque radiotherapy patients appearing to fare better. However,
when patients with small or medium tumors were compared, only slight
differences were seen, implying that criteria used to select patients for
treatment may affect interpretation. The two groups were also compared
using the Cox proportional hazards model, which predicts survival based on
the impact of clinical variables. In this analysis, the survival rates of
the plaque radiotherapy group were no worse than those of the enucleation
group. The advantage of conservative therapy lies in the potential to
preserve useful vision over a considerable time. Because patients were
specifically selected for treatment modality and because the study size
used to calibrate the Cox model was small, the results of this study must
be interpreted with caution.
