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Emine Kilic, MD; Theo Stijnen, PhD; Paulus T. V. M. de Jong, MD, PhD; Cornelia M. Mooy, MD, PhD; Wilhelmina M. H. Eijkenboom, MD, PhD; Peter J. Ringens, MD, PhD; Gre P. M. Luyten, MD, PhD

Arch Ophthalmol. 2005;123:1363-1367.

Background  Radiotherapy of an eye before enucleation, so called preenucleation radiotherapy (PER), of patients with uveal melanoma was initiated to reduce enucleation-induced systemic metastasis. Earlier studies with a short follow-up period have not demonstrated a significant effect on survival.

Objective  To study the effect of PER on melanoma-related mortality after more than 9 years of follow-up.

Design  In a prospective study, 167 patients with uveal melanoma were treated between 1978 and 1992 by irradiation with 800 rad (8 Gy) given in 2 fractions 2 days before enucleation. A group of 108 patients with uveal melanoma treated between 1971 and 1992 by enucleation only in the same hospital served as a historical control group. Patients were followed up until December 2002 or death.

Results  Melanoma-related death occurred in 32.3% of the PER-treated group and in 40.7% of the enucleation only group. Mean follow-up was 9.25 years. After 48 months of follow-up, a significant difference in survival became evident in favor of the PER group. The estimated 15-year survival rates for patients with melanoma in the PER group and enucleation only group were 63.7% and 51.0%, respectively. For patients dying of all causes, these percentages were 47.5% and 25.2%, respectively. In both groups, women had a better prognostic outcome than men.

Conclusion  This study suggests that PER improves long-term survival in patients with uveal melanoma.

Author Affiliations: Departments of Ophthalmology (Drs Kilic and Luyten), Epidemiology and Biostatistics (Drs Stijnen and de Jong), Pathology (Dr Mooy), and Radiotherapy (Dr Eijkenboom), Erasmus MC, and The Eye Hospital (Dr Ringens), Rotterdam, and Ophthalmic Research Institute, Royal Academy of Arts and Sciences, and Department of Ophthalmology, Academic Medical Center, Amsterdam (Dr de Jong), the Netherlands.

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