Brachytherapy for patients with uveal melanoma: historical perspectives and future treatment directions

Figures & data

Table 1 Considerations for uveal melanoma-plaque brachytherapy candidates

Good candidates

• Small tumor with documented growth

• Medium tumor size

• Large tumor (visual outcomes may be compromised)

Candidates with additional counseling recommendations(higher rates of visual compromise, tumor recurrence, lossof eye)

• Large tumor

• Peripapillary tumor

• Extrascleral extension

Poor candidates

• Extensive circumpapillary/peripapillary location involvement (slottedplaque may increase treatment options)^Citation49

• Bulky extrascleral extension

• Ring melanoma

• Tumor involvement of more than half the ciliary body

• Very large tumor (exceeds diameter limits of brachytherapy)

• Blind, painful eyes

Table 2 Summary of molecular markers of metastasis in uveal melanoma

Molecular markers of decreased risk of metastasis

– Gain of chromosome 6p

– EIF1AX gene mutation

– GEP class 1A

Molecular markers of intermediate risk of metastasis

– SF3B1 gene mutation

– GEP class 1B

Molecular markers of high risk of metastasis

– Monosomy of chromosome 3 and gain of 8q

– BAP1 gene mutation

– GEP class 2

Abbreviation: GEP, gene-expression profile.

Table 3 Reported rates of complications of FNAB

Complications of FNAB	Reported complication rates	References
Persistent hemorrhage	0–4.1%	^Citation101^–^Citation103, ^Citation115
Retinal detachment	0–1%	^Citation101^–^Citation103, ^Citation115
Local recurrence of uveal melanoma	0–0.2%	^Citation100^–^Citation103, ^Citation123
Endophthalmitis	0	^Citation100^–^Citation103, ^Citation115

Abbreviation: FNAB, fine-needle-aspiration biopsy.

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