Treatment of Localised Primary Uveal Melanoma When Eye-Preserving Treatment Is Feasible
When uveal melanoma is diagnosed at a localised, primary stage and the tumour is amenable to eye-preserving techniques, established radiotherapy-based approaches are preferred over surgical resection options.
Clinical Scenario
Localised primary uveal melanoma in a patient where eye-preserving local treatment is technically possible. Evidence supports prioritising radiotherapy approaches in this setting, sparing the eye while achieving local disease control.
Treatment Approach
Radiotherapy is the cornerstone of management in this setting. Multiple radiotherapy modalities are available, and the choice between them depends on institutional availability and individual case factors. An adjunct intervention to prevent a specific intraocular complication is also incorporated into the regimen.
The full structured regimen — including which radiotherapy modality to select, the specific associated intervention, and the complete decision algorithm — is available in the protocol.
References
DOI: 10.1016/j.esmoop.2026.106888
- If eye-preserving techniques are possible, RT options should be preferred over endo- and transscleral resections [I, B].
- Brachytherapy or PBR can be used as both are associated with excellent results in terms of local control [III, A].
- SRT is an alternative with limited prospective validation [IV, B].
- The recommended total doses of PBR are 60 Gy in four fractions, or 50 or 70 Gy in five fractions [III, A].
- Intravitreal anti-VEGF therapy is recommended to prevent the formation of intraocular neovascularisation [IV, B].
View source ↗