Aktuelle Tagungsinformationen
News and Updates
Anmeldung zur Tagung
Registration
Hotelbuchung
Hotel Registration
Grußwort
Welcome address
Beteiligte Gesellschaften
Societies involved
Eröffnung des Kongresses
Opening Ceremony
Preise
Awards
Wissenschaftliches Programm
Scientific program
Posterpräsentationen
Poster Presentation
Kurse
Courses
Begleitende Veranstaltungen
Collateral Events
Rahmenprogramm
Social program
Jubiläumsparty
Jubilee Party
DOG Information
DOG Information
Allgemeine Informationen
General Information
Autorenindex
Index of Authors
Ausstellerliste
Exhibitors
Sponsoren
Sponsors
Teilnahmegebühren
Registration fees
Impressum
DOG Homepage
Current Therapy of Uveal Melanoma
Foerster M. H.,
Freie Universität Berlin, Klinikum Benjamin Franklin, Augenklinik (Berlin)
Within the last twenty years we have faced a considerable change of treatment concepts in uveal melanoma, giving better visual results and eye retention rates. However, the tumor related mortality has remained unchanged. In the early phases photocoagulation and evolving plaque radiotherapies were in the focus of interest. Today we have a number of different treatment modalities suitable for different localizations. Photocoagulation as a primary therapy was discontinued. Transpupillary Thermotherapy alone or in combination with plaque therapy, has been developed in the last years. However, the initial optimism has been subdued since the identification of significant risk factors in amelanotic tumors, as well as juxtapapillary- and intrascleral infiltration. The mainstay of uveal melanoma treatment remains plaque brachytherapy, although it has evolved in the last decades. Today in most countries ruthenium, iodine, as well as iridium and palladium plaques are used. A core problem in radiation modalties concerns the secondary morbidity due to tumor necrosis and radiation induced vasculopathy. Secondary glaucoma is a common complication, as well as functional loss and enucleation in large tumors. Proton beam irradiation introduced in Boston in 1975 is available in Berlin since 1998. It has enlarged the therapeutic options for tumor treatment. The physical advantages are steep dose reduction, calculation and configuration of the radiation volume and optimized target dose sparing neighboring vital structures of tumors close to disc and macula. Transscleral resection in combination with ruthenium brachytherapy and transvitreal endoresection combined with Proton irradiation as a primary treatment option have been established in the last four years for large intraocular tumors. With these methods it is possible to achieve better visual results and a lower enucleation rate, when compared to radiotherapy alone.