PRE-ENUCLEATION IRRADIATION OF UVEAL MELANOMA

The relative efficacy of various types of treatment in preventing metastatic uveal melanoma is unclear. A phase I-II nonrandomized trial to determine if patients with large (> 15 mm in diameter or > 5 mm in thickness) uveal melanomas would benefit from preenucleation irradiation was performed. Patients (28) were treated between 1978 and 1983 by means of 5 .times. 5 cm anterior wedge pair ports on a 4 me V linear accelerator. Each patient received five 4 gray (400 rad) fractions over a 5-day period for a total of 20 gray. Enucleation was performed by a single surgeon within 5 days after treatment. The mean follow-up of the patients was 24 mo. (range 7-54 mo.). All melanomas were histologically confirmed. Four patients (14%) developed metastic tumors with a mean interval between diagnosis and death of 25 mo. No significant perioperative or long-term morbidity was observed.