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Clinical management of uveal melanoma: a comprehensive review with a treatment algorithm

Radiation Oncology Journal 2020년 38권 3호 p.162 ~ 169
Sayan Mutlay, Mamidanna Swati, Oncel Damla, Jan Imraan, Vergalasova Irina, Weiner Joseph P., Ohri Nisha, Acikalin Banu, Chundury Anupama,
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 ( Sayan Mutlay ) - Rutgers Cancer Institute of New Jersey Department of Radiation Oncology
 ( Mamidanna Swati ) - Rutgers Cancer Institute of New Jersey Department of Radiation Oncology
 ( Oncel Damla ) - University of California Department of Biochemistry
 ( Jan Imraan ) - Rutgers Cancer Institute of New Jersey Department of Radiation Oncology
 ( Vergalasova Irina ) - Rutgers Cancer Institute of New Jersey Department of Radiation Oncology
 ( Weiner Joseph P. ) - Rutgers Cancer Institute of New Jersey Department of Radiation Oncology
 ( Ohri Nisha ) - Rutgers Cancer Institute of New Jersey Department of Radiation Oncology
 ( Acikalin Banu ) - Istanbul Fatih Sultan Mehmet Education and Research Hospital Department of Ophthalmology
 ( Chundury Anupama ) - Rutgers Cancer Institute of New Jersey Department of Radiation Oncology

Abstract


Uveal melanoma (UM), the most frequently occurring non-cutaneous melanoma and most common primary intraocular malignancy in adults, arises from the melanocytes of the choroid in approximately 95% of cases. Prompt diagnosis and treatment is vital as primary tumor size is one of the key factors associated with survival. Despite recent advances in management, more than half of the patients develop metastatic disease which portends poor survival. Currently, treatment options for UM include local resection, enucleation, plaque brachytherapy, and/or particle beam radiotherapy (RT). Enucleation was initially the standard of care in the management of UM, but a shift towards eye-preserving therapeutic choices such as RT and local resection has been noted in recent decades. Plaque brachytherapy, a form of localized RT, is the most popular option and is now the preferred treatment modality for a majority of UM cases. In this review we discuss the etiopathogenesis, clinical presentation and diagnosis of UM and place a special emphasis on its therapeutic options. Furthermore, we review the current literature on UM management and propose a functional treatment algorithm for non-metastatic disease.

키워드

Uveal melanoma; Surgery; Radiotherapy; Brachytherapy

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