Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Parvizi, M.
Longterm outcome after transpupillary thermotherapy of choroidal melanoma -established or experimental therapy?
[ Diplomarbeit/Master Thesis ] Graz Medical University; 2008. pp.86.
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- Autor*innen der Med Uni Graz:
- Parvizi Marjan
- Betreuer*innen:
- Langmann Gerald
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- Abstract:
- Purpose The purpose of this study was to evaluate ocular and systemic longterm outcomes after transpupillary thermotherapy ( TTT) for small choroidal melanoma vrs indeterminate pigmented lesions treated at the Department of ophthalmology, Medical University Graz between 1995 and 2008. Methods We retrospectively reviewed 28 patients with the diagnosis small choroidal melanoma vrs indeterminate pigmented lesions who underwent primary transpupillary thermotherapy (TTT). Patients with choroidal melanoma posterior to the equator with a mean basal diameter of 9,5mm and thickness of 3,3mm were treated with TTT, as soon as the lesion showed documented growth or had risk factors for growth or development of metastases. Patients data were collected according to: tumor characteristics, treatment response, visual acuity, mortality and complications. Results Fifteen women and thirteen men with a mean age of 67 years underwent TTT. The mean preoperative tumor thickness was 3,3mm (median 3mm, range 1,1-7,8mm). The mean follow-up time was 74 months (median 72 months, range 0,3 -172 months). After a mean of 2 TTT sessions (median 2, range 1-10) we achieved tumor regression in 71%. In 6 patients (21%) we had recurrences, which were successfully treated with additional TTT, Ruthenium-106 brachytherapy or Gamma Knife stereotactic radiosurgery. The mean time to recurrence was 39 months (median 29 months, range 7-107 months). Two of our patients underwent enucleation. In one case we had tumor-related death, three months after TTT. The mean initial visual acuity was 20/35 Snellen (median 20/35 Snellen, range 020/20 Snellen) and after the last follow-up 20/70 Snellen (median 20/200 Snellen, range 020/20 Snellen). Conclusion Transpupillary Thermotherapy proved another successful globe preserving treatment with a primary success rate of 71%. It has a high recurrence rate of 21%, recurrent tumors were successfully treated with additional TTT or Ruthenium-106 brachytherapy or Gamma Knife radiosurgery. The 5-year and 10-year survival rate of our patients were 96%. In order to come to a final conclusion about the efficacy of TTT a prospective randomised study with the same inclusion criterions and a standardised technical procedure seems mandatory.