Role of Radiation for Intra-ocular Eye Tumours

A variety of malignant tumours can affect the structures that make up the eye. Many of these tumours are melanomas, but other malignancies, such as adenocarcinomas, lymphomas, or nerve tumours such as gliomas of the optic nerve can occur.

Radiation is used as an alternative to surgery, which may result in the loss of the eye (enucleation). Radiation can be administered using brachytherapy techniques, either through an Iodine-125 plaque, or external beam stereotactic radiation depending on the location of the tumour in the eye. Low-dose external beam techniques may also be used for radiosensitive tumours like lymphoma or leukemia, or metastatic tumours to the eye.

Indications 

• Choroidal (uveal) melanoma as an alternative to surgery
• Melanoma and adenocarcinoma of ciliary body or iris when surgery is not possible 
• Optic nerve tumours such as melanocytoma or gliomas if and when treatment is needed
• Intraocular lymphoma as an emergency in the case of impending visual loss
• Metastatic carcinoma or leukemia

Benefits

Radiotherapy for small to medium size melanomas produces equivalent survival rates, with retention of the eye in most cases. In some cases, the eye is eventually lost due to tumour recurrence or radiation related ocular complications. Cancer control rates following stereotactic radiation are high, although depending on the location of the tumour in the eye, retinal damage might lead to loss of vision.

Low-dose radiotherapy is a useful emergency procedure in cases of impending visual loss from ocular lymphoma. External beam radiotherapy is a standard treatment for metastatic carcinoma or leukemia, particularly if vision is failing. It is usually given to both orbits and/or the brain, depending on the distribution of disease. There are few adverse effects. Metastatic lesions usually respond promptly often with improved vision for the remainder of the patient’s life.

How to Obtain a Referral

Opinions from Radiation Oncology and/or Ophthalmology regarding management or treatment of ocular/orbital structures, including effects of chemotherapy or radiotherapy on normal tissues can be obtained by contacting:

Lee Penney
Manager, Ocular Oncology Clinic
Tel: (416) 946-4501 ext 5430
Fax: 416-946-2189

Inquiries may also be made directly to Drs Payne, Laperriere, or Millar.

This page was last updated August 3rd, 2010 at 2:25pm.