Radiation Oncology/Eye/Choroidal metastasis

Prevalence
In disseminated breast cancer:
 * PMID 9924304 &mdash; "Frequency of asymptomatic choroidal metastasis in patients with disseminated breast cancer: results of a prospective screening programme." Wiegel T et al.
 * Risk was 5%. Higher risk of 11% when more than one organ was involved in metastatic spread. Risk factors were lung and brain metastases.

Prospective trials

 * German ARO 95-08 (1994-98)
 * 50 pts with 65 involved eyes. Treated 40 Gy in 20 fractions.
 * 2002 PMID 12208569 -- "External beam radiotherapy of choroidal metastases--final results of a prospective study of the German Cancer Society (ARO 95-08)." (Wiegel T, Radiother Oncol. 2002 Jul;64(1):13-8.)
 * Median f/u 5.8 months. MS 7 mo. Improvement in visual acuity in 36%, stable in 50%, decreased in 14%.
 * Conclusion: Radiation therapy with 40 Gy is an effective and safe palliative treatment for symptomatic and asymptomatic choroidal metastases to preserve vision in the majority of the patients. A unilateral field for unilateral metastasis seems to be sufficient to prevent contralateral disease.