Ten-year follow-up of helium ion therapy for uveal melanoma.

Abstract

To examine the results of helium ion irradiation in 218 patients with uveal melanoma treated more than 10 years ago. A retrospective review was made of 218 patients (218 eyes) treated with helium ion radiation for uveal melanoma between 1978 and 1984. After helium ion irradiation, 208 (95.4%) of 218 eyes had local tumor control. Ten years after irradiation, 46 (22.4%) of 218 eyes had been enucleated; the majority of enucleations (37 of 46) resulted from anterior ocular segment complications. Ten years after radiation, 102 (46.8%) of the 218 patients were dead; 51 had non-melanoma-related deaths and 51 had died of metastatic melanoma. Best-corrected visual acuity after radiation was greater than 20/40 in 21 (23%) of 93 eyes of the patients who were alive and who had retained their eyes 10 or more years after treatment. In patients with tumors less than 6 mm in height and more than 3 mm distant from the nerve or the fovea, 13 (72%) of 18 retained visual acuity greater than 20/40. In contrast, only 11% of the patients with either thicker tumors or those close to the nerve or fovea retained that level of visual acuity. Helium ion irradiation of uveal melanoma is associated with good local tumor control and reasonable retention of the treated eye 10 years after treatment. In eyes with tumors less than 6 mm in thickness and more than 3 mm distant from the optic nerve and fovea, many retain excellent vision.