MAR 31, 2009
By Arun D. Singh, MD
Ocular Pathology/Oncology
The use of transpupillary thermotherapy (TTT) was initially described in the medical literature in combination with plaque radiotherapy but has more recently been used as primary or sole therapy for ''small'' choroidal melanocytic lesions, melanomas or high-risk nevi with or without documented growth. The current editorial, of which I am the primary author, involved a systematic analysis of all 10 relevant published studies on TTT as primary therapy for this indication to determine local tumor recurrence rates.
We calculated a mean tumor recurrence rate of 17 percent, with a range of 8 to 56 percent and a median follow-up of three years. We concluded that delayed high local recurrence rates following sole therapy with TTT are a concern.
As we wrote in our editorial, tumor recurrence may be associated with increased risk of metastasis. Other treatments, such as proton or plaque radiotherapy, have reported tumor control rates greater than 90 percent. However, there may be a greater chance of visual loss with radiotherapy compared with TTT.
Financial Disclosures
Dr. Singh has no financial interests to disclose.