Comparison of prognosis after enucleation vs cobalt 60 irradiation of melanomas
J. D. Gass
Between December 1962 and May 1979, growth of choroidal and ciliary body
melanomas was documented in 34 patients prior to enucleation. Twenty-seven
of the 34 patients underwent enucleation during the same time period (1967
through 1976), when primary treatment with a cobalt 60 episcleral plaque
was employed in a nonrandomized fashion in 21 patients with similar-sized
melanomas. Comparison of these two groups of patients, none of whom was
unavailable for follow-up and all of whom were followed up for a minimum of
66 months, showed that the probability of dying of metastatic melanoma
within five years after cobalt 60 therapy was 50% compared with 16% after
enucleation. Factors of potential importance in explaining this difference
included nonrandomization, small number of patients in both groups, and
greater frequency of anterior location of tumors in the cobalt 60 group
(76% vs 22%). A randomized, controlled clinical trial is required to
determine the relative safety of treatment for uveal melanomas.
