Brachytherapy for Uveal Melanoma: Is the Dose Too High?

Lower radiation doses and personalized plaque design could balance tumor control with vision preservation.

By: Jose J. Echegaray, MD, Soumaya Bouhout, MD, Arun D. Singh, MD

Retinal Physician September 1, 2025 Vol 22, Issue September 2025 Page(s): 18-20

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The COMS established 85 Gy as the standard dose for medium-sized uveal melanoma, aiming for tumor control while minimizing vision complications.
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Evidence suggests lower doses may be effective, particularly for smaller tumors, with studies showing no significant link between higher doses and reduced recurrence.
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Custom plaque designs, like Eye Physics, can reduce radiation exposure to critical structures while maintaining tumor control, indicating the importance of individualized treatment.
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Current practices show variation in brachytherapy dosing, with some centers reducing doses for small tumors, highlighting a shift towards personalized treatment strategies.
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Future research should focus on comparing reduced-dose regimens using modern imaging and dosimetry to balance tumor control with visual preservation.

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