The Effectiveness of Radiowave Surgery in the Treatment of Patients with Melanoma of Iris, Ciliary Body and Choroid

Abstract

The purpose of the study was to investigate the effectiveness of radiowave surgery in the treatment of uveal melanoma. Materials and Methods: The study was performed on the basis of the oncoophthalmology department of the State Institution «Institute of Eye Diseases and Tissue Therapy named by academician V.P. Filatov of the NAMS of Ukraine» during 2009-2019. Treatment with radio wave knife "Surgitron" manufactured by "Ellman International", was performed in 71 patients with melanoma of the iridociliary and chorioid (mean age 55.7 ± 1.6 years, minimum age 20 years, maximum age 77 years, Me (25%, 75%) = 59.0 (46.0; 65.0). These patients were split into two groups: 45 (61.6%) patients with melanoma localization in the iris and ciliary body (I group) and 28 (38.4%) patients with melanoma mostly affecting the ciliary body and choroidea (II group). In patients with melanoma of the ciliary choroidal region, a 40-day course of external β-therapy (Sr90+ Y90) was performed (25-30‘, RD = 40 Gy, LAD = 400 Gy). The follow-up period after the intervention was 10 years. Statistical analysis was performed by analysis of variance using Statistica 13.0 software (Dell StatSoft Inc, USA). Results and Discussion: The use of a radio wave knife in resection of the UM allowed to maintain the ascending visual acuity in 100% operated for 12 months. The frequency of eye subatrophy in the subsequent stages of observation did not exceed 5%. The frequency of tumor recurrence when using a radio wave knife within 24 months of observation does not exceed 15%. The incidence of postoperative complications with the use of a radio wave knife does not exceed 5%. Low incidence of complications and recurrences, better five-year survival rate using radiowave surgical method allows to recommend it for wide use in combined treatment of uveal melanoma. Conclusion: Radiowave knife is safe and clinically effective method of surgical treatment of uveal melanoma.