Fractionated stereotactic radiotherapy for uveal melanoma

With an annual incidence of about 4 to 9 per million in the United States of America and European countries, uveal melanoma (UM) is a rather rare malignant disease entity [1]. UM can arise in any part of the uveal tract, that is in the iris, ciliary body and/or choroid. Iris melanomas are extremely uncommon and have a different nature as well as treatment approach. This thesis will only relate UM to choroidal and ciliary body melanomas, which take up 95% of all UM. Most the patients are diagnosed with UM because of having (mild) visual symptoms, such as blurred and/or declined vision, light flashes, metamorphopsia (change in shape of an object) and floaters (“floating flies”). Although effective local treatment options for the primary tumor, are available, a substantial part of the patients eventually die from metastatic disease. UM metastasize haematogenously, mainly to the liver. The diagnosis of metastatic uveal melanoma disease is often several years after the primary treatment, with a median of 4 to 6 years. Once (liver) metastases have been diagnosed, the prognosis is infaust in almost all cases with a mean survival of 3 to 9 months.

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