Significance of adjuvant external beam radiotherapy of the orbit in managing uveal melanoma with extraocular extension.

Authors

Nathalie Christina Düsberg, Norbert Bornfeld, Anja Merkel-Jens, Philipp Rating, Michael Zeschnigk, Wolfgang A C Sauerwein, Martin Stuschke, Maja Guberina, Nikolaos E Bechrakis, Eva Biewald

Published in

BMJ open ophthalmology. Volume 11. Issue 3. Sep 11, 2026. Epub Sep 11, 2026.

Abstract

Extraocular extension (EOE) is a known risk factor for metastasis in uveal melanoma. This long-term study investigates neoadjuvant and adjuvant external beam radiotherapy (EBRT) before and after enucleation of eyes with uveal melanoma and EOE with respect to survival, local tumour control, metastatic disease and side effects of radiotherapy.
Retrospective, consecutive analysis of all patients with enucleation for uveal melanoma and histopathological evidence of EOE from June 1980 to April 2014.
The entire cohort comprised 87 patients. 34 of those were lost to follow-up. Of the remaining 43 patients, 26 underwent adjuvant and/or neoadjuvant radiotherapy with a total orbital dose of 50-60 Gy, while the remaining 17 were treated with enucleation only. The mean follow-up time was 65.58±80.44 months (median 37 months) and 184.12±119.760 months (median 132 months) for those being alive at last follow-up. EBRT patients had significantly higher TNM (tumour, node, metastases) stages (p=0.033) and more extensive EOE (p=0.146). There was no significant difference in any relevant parameters between the two groups. The overall survival rate after 5 and 10 years was 32.6% and 16.2%, respectively. There was no evidence of a significantly later (p=0.573) or less frequent (p=0.999) occurrence of metastases in either group. There were no local recurrences in either group. Side effects of the radiotherapy occurred in 61.5%.
Adjuvant or neoadjuvant EBRT had no survival benefit in uveal melanoma with EOE. No local recurrence was detected in either group.

PMID:
42728088
Bibliographic data and abstract were imported from PubMed on 12 Sep 2026.

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