choroidal haemangioma (eye lesion)

Master ShreeVaishnav – Kerala, India 
Radiation therapy is one of the most important tools to combat cancer. However, conventional radiation therapy is long course (usually 6 to 7 weeks) treatment and may have severe acute side effects including skin and mucosal reactions, diarrhea, feeding difficulties and others. Higher dose radiation is also not possible to deliver due to limitations related to toxicities. CyberKnife is a precise radiation therapy technique by which high dose radiation therapy can be delivered only to the tumor and minimal dose to the normal structures. CyberKnife treatment is a short course treatment (usually only one to 5 days) and have no or minimal side effects. Many tumors which are ‘resistant’ to conventional radiation are ‘sensitive’ to high dose radiation delivered by CyberKnife. “CyberKnife has unique system that it can track moving tumors and treat them with immaculate accuracy”. Tumors in moving organs such as lung and liver can be treated most effectively CyberKnife. Dr Debnarayan Dutta, Consultant in Radiation Oncology at Apollo Speciality Hospital, Chennai commented “there are few tumors which were thought to be not treatable are now being treated successfully with CyberKnife”.

Master ShreeVaishnav, a 6 year old boy from Kerala suffering with choroidal haemangioma (eye lesion) had vision loss in both the eyes, he was referred from Sankar Netralaya for treatment. He was treated with CyberKnife and at 2 months follow up evaluation his vision had dramatically improved. “We are thankful to Dr Dutta for giving vision back to my son” told ShreeVaishnav’s father who was elated about CyberKnife. “CyberKnife has opened a modern and effective option for these diseases and we are happy with the result” said Dr Prativa Mishra, eye specialist involved in ShreeVaishnav’s treatment.

CyberKnife is a revolution in cancer treatment; it provides effective, short course, minimal toxic and high dose treatment in brain, lung, liver, pancreas, prostate, head and neck and many other tumors.

To know more about cyberknife kindly blog your comments or you can write to me atlakshmipriya_b@apollohospitals.com or call 9940675877

organ preserving treatment for small localized choroid melanoma

Title: Radiosurgery with CyberKnife as an organ preserving treatment for small localized choroid melanoma
Authors: KR Prasanna Kumar*, MBBS; Debnarayan Dutta*, MD; Prativa Mishra^, MS; Raghunandhan* MD; P Mahadev * MD, DNB; AN Vaidhyswaran* MD; Sanjay Chandrasekhar* MD; Janos Stumpf *MD, PhD; Rathnadevi* DMRT; V Murali# PhD; PG Kurup# PhD;
*Department of Radiation Oncology, #Medical Physics, Apollo Speciality Hospital, Chennai
^Department of Opthalmology, Apollo Speciality Hospital, Chennai


Abstract



Aim: To evaluate robotic radiosurgery as an organ preserving treatment for localized choroid melanoma of the eye.
Case report: Thirty six year old female patient had complaint of progressive dimness of vision of right eye for six months. Fundoscopy examination showed small lesion (2.5 x 2.5 mm) in macular region. 320 slices CT scan showed organ confined 2.5 x 2.5 mm nodular lesion in the macular region (3 mm superior and 2.5 mm temporal to the origin of optic nerve at fovea) of right eye and was diagnosed with localized choroid melanoma of right eye (visual acuity 6/18 ). Metastatic workup was normal. She was planned for SRS (CyberKnife) as an organ preserving approach. Planning CT scan and CyberKnife treatment (dose 18 Gy single fraction, prescription isodose 85%; treatment time 22 min, GTV 111.6 mm3, 2mm PTV margin, PTV 403 mm3) were done with retro-bulbar anesthesia. Mean dose to right eye, left eye, right eye lens and pituitary gland was 4.9, 0.4, 0.4 and 1 Gy respectively. Maximum dose to optic chiasm, brainstem, right (2% vol) and left optic nerve were 1.4, 2.1, 15 and 0.4 Gy respectively. Skull tracking method was used as tumour tracking method. She completed treatment without any acute complication and visual acuity was preserved.
Conclusion: Robotic radiosurgery is a feasible, acceptable and an appropriate treatment modality as organ preserving approach in small choroid melanomas.

Keywords: Choroid melanoma, Robotic radiosurgery, Organ preserving approach