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Top Line: Is stereotactic radiosurgery (SRS) an effective option for treating uveal melanoma?

The Study: Plaque brachytherapy and particle therapy are the standard treatment options for uveal melanoma. While photon-based SRS has been used, there is very limited data describing treatment outcomes with SRS. This meta-analysis describes treatment outcomes for single-fraction gamma knife SRS. It included 28 studies with over 1000 patients were analyzed and the vast majority of patients (97%) had uveal melanoma while the remainder had ocular metastases from other primary tumor sites. A broad range of marginal doses were used (ranging from 16 Gy to 59 Gy), and the median prescription dose was 32 Gy. Local control across all studies was 96%, and the rate of tumor regression was 81%. Around 30% of patients across studies experienced treatment-related complications, and 5.4% of patients required enucleation for treatment failure. While the efficacy and safety of GK SRS in this meta-analysis appears comparable with prospective plaque brachytherapy data, most of the data in this study was from small retrospective series and there was significant heterogeneity in technique and outcome reporting.

TBL: Granted the limited amount of data and variability in technique, this meta-analysis shows favorable local control and toxicity with gamma knife SRS for uveal melanoma. | Parker, Lancet Oncol 2020