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

PURPOSE: To examine the results of helium ion irradiation in 218 patients with uveal melanoma treated more than 10 years ago. METHOD: A retrospective review was made of 218 patients (218 eyes) treated with helium ion radiation for uveal melanoma between 1978 and 1984. RESULTS: 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. CONCLUSIONS: 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.