The potential for adjuvant radiotherapy in choroidal melanoma
D. H. Char and T. L. Phillips
Controversy exists regarding the efficacy of enucleation in the management
of choroidal melanoma. The effect of any form of ocular therapy on the
prevalence of choroidal melanoma metastases is unknown. In a number of
other systemic tumors, preoperative irradiation may lessen the occurrence
of widespread disease. This type of therapeutic approach might be useful in
the management of high-risk choroidal melanoma. In preliminary studies
using 2,000 rad of preenucleation irradiation in patients with choroidal
melanoma who have a poor prognosis, we have not observed notable morbidity.
There are a number of limitations to the use of this adjunct therapy in
choroidal melanoma management; however, a prospective national randomized
trial of preenucleation irradiation in patients with high-risk choroidal
melanoma might allow us to indirectly determine the effect of enucleation
on the prevalence of choroidal melanoma metastases as well as delineate the
potential role of this type of adjunct therapy in ocular melanoma.
