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OHSU Researchers Compare Treatments for Ocular Cancer

   Portland, Ore.

Survival rates for radiation therapy and removal of the eye are nearly the same

New research demonstrates that patients with cancerous ocular tumors who receive radiation therapy have comparable survival rates to those who undergo surgery involving removal of the eye. This study helps answer questions in the medical community about whether one treatment might provide higher odds of survival than the other. The information also will be useful for patients deciding whether they would opt for treatment of their ocular tumors versus removal of the eye. The Casey Eye Institute at Oregon Health & Science University was one of 43 eye centers across the United States to take part in the national clinical trial. Research results are printed in the July 12 edition of the Archives of Ophthalmology, a publication of the American Medical Association.

A total of 1,200 adult patients with medium-sized eye tumors took part in the 15-year Collaborative Ocular Melanoma Study (COMS). These tumors, called choroidal melanomas, form in the choroid, a layer of tissue in the back of the eye. It is the most common primary eye cancer in adults. These tumors can result in vision loss and may spread, or metastasize, to other parts of the body.

Half of the patients in the trial underwent FDA-approved radiation treatment, called I-125 brachytherapy, in which a coin-sized plaque containing radioactive iodine pellets was temporarily applied to the eye to shrink the ocular tumors. Interest in this type of therapy has steadily grown over the past 25 years because of the potential for saving the eye. The other half of the patients had the cancerous eye surgically removed. Upon review of the research data, researchers found that the 10-year and five-year survival rates for patients in the surgery and radiation treatment groups were essentially the same.

"The five-year survival rate for patients in both treatment groups was 82 percent," said David Wilson, M.D., OHSU's principal investigator in the study and an associate professor of ophthalmology in OHSU's School of Medicine. The actual difference in the survival rates for this time period was fractional. "It is believed that these findings will make it possible for both patients and physicians to make better-informed treatment decisions."

The average patient who underwent radiation therapy had some vision loss in the treated eye. However, some patients maintained near normal vision

The COMS study was supported by the National Eye Institute (NEI) and the National Cancer Institute, two components of the National Institutes of Health.

"These findings are reassuring to patients with medium-sized eye tumors who have to choose between the option of radiation therapy versus removal of the eye," said Paul A. Sieving, M.D., Ph.D., director of the NEI. "Patients now know that their choice will not impact their survival."

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