Clinical outcomes of Modified Collaborative Ocular Melanoma Study IRIS plaques for treatment of iris, iridociliary, and ciliary body melanoma

• Published in: Eye (London) Vol. 35; no. 10; pp. 2754 - 2762
• Main Authors: Xu, Timothy T., Pulido, Jose S., Deufel, Christopher L., Corbin, Kimberly S., Petersen, Ivy A., Dalvin, Lauren A.
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.10.2021; Nature Publishing Group
• Subjects: 631/67/1484; 692/308/409; Acuity; Adult; Aged; Aged, 80 and over; Brachytherapy; Cataracts; Ciliary Body; Clinical outcomes; Cohort Studies; Collaboration; Demography; Enucleation; Eye Enucleation; Female; Follow-Up Studies; Humans; Iris; Iris Neoplasms - radiotherapy; Iris Neoplasms - surgery; Laboratory Medicine; Medical records; Medicine; Medicine & Public Health; Melanoma; Melanoma - surgery; Metastases; Metastasis; Metastatic seeding; Middle Aged; Ophthalmology; Pharmaceutical Sciences/Technology; Plaques; Radiation; Radiation therapy; Retrospective Studies; Side effects; Surgery; Surgical Oncology; Treatment Outcome; Tumors; Young Adult
• ISSN: 0950-222X; 1476-5454; 1476-5454
• DOI: 10.1038/s41433-020-01295-y

Background/objectives To report clinical outcomes of modified Collaborative Ocular Melanoma Study IRIS (COMS IRIS) plaques for treatment of iris, iridociliary, and ciliary body melanoma. Subjects/methods Retrospective, single-centre cohort study of iris melanoma treated with COMS IRIS plaque radiotherapy from July 26, 2010 to October 15, 2018. Medical records were reviewed for demographics, tumour features, treatment parameters, and clinical outcomes. Results There were 22 cases, diagnosed at mean age of 59 years (median 65, range 21–85 years) with female sex in 14 (64%). Presenting tumour features included Snellen visual acuity (VA) ≥ 20/40 in 18 (82%) cases, mean largest tumour basal diameter 4.7 mm (median 3.9, range 2.3–13.8 mm) and thickness 1.7 mm (median 1.6 mm, range 0.8–3.9 mm), iris stromal seeding in 3 (14%) cases, angle seeding in 16 (73%), and ciliary body involvement in 13 (59%). After mean follow-up of 51 months (median 44, range 4–113 months), Snellen VA was ≥20/40 in 14 (64%) cases, with local tumour recurrence in 2 (9%), and enucleation in 2 (9%). The 3-year Kaplan–Meier estimated risk of local tumour recurrence was 7%. The most common radiation side effects were cataract in 17 (77%) patients and dry eye in 5 (23%). Systemic metastasis occurred in no cases, and 1 (5%) non-melanoma-related death due to natural causes was observed at last follow-up. Conclusions COMS IRIS plaques are effective for treatment of iris, iridociliary, and ciliary body melanoma with modest VA outcomes and low frequency of local tumour recurrence, enucleation, radiation side effects, and systemic metastasis.