Standardized Precision Radiotherapy in Choroidal Metastases

Abstract

Metastases in the choroid of the eye are frequent in patients with disseminated malignancy. We here report the results using the precision radiotherapy technique described by Schipper et al. to treat 14 of 17 consecutive patients (21 eyes) with symptoms from such metastases. A beam defining col lima tor was used and a lateral field was given with the treated eye individually fixed. Varying fractionations and doses were used. The biologically effective dose for early effects (BED₃) was 47 to 90 Gy and for late effects (BED₁₀) 28 to 59 Gy. In 14 eyes (82%) the metastases regressed completely. The visual acuity was stabilized or improved in all patients and none needed local surgery. Three patients developed signs of radiation retinopathy, but only in one case the visual function was compromized. With this standardized technique no individualized dose planning was needed, the risk of radiation cataract was minimized and a dry eye avoided.