Original Articles: Clinical ResearchRobotic CyberKnife radiosurgery for small choroidal melanomasSchmelter, Valeriea; Hofmann, Theresab; Schneider, Frederickc; Weber, Constanced; Fuerweger, Christophb; Muacevic, Alexanderb; Priglinger, Siegfried G.a; Foerster, Paula; Liegl, Raffaela,d Author Information aDepartment of Ophthalmology, University Hospital, LMU Munich bEuropean CyberKnife Center Munich cDepartment of Anaesthesiology, TUM School of Medicine, Technical University of Munich, Munich dDepartment of Ophthalmology, University Eye Hospital, University of Bonn, Bonn, Germany Received 28 July 2021 Accepted 9 March 2022 Correspondence to Valerie Schmelter, MD, Department of Ophthalmology, Ludwig-Maximilians Universität, Mathildenstr. 8, 80336 Munich, Germany, Tel: +49 89 440053080; fax: +49 89 440055160; e-mail: [email protected] Melanoma Research 32(3):p 192-199, June 2022. | DOI: 10.1097/CMR.0000000000000823 Buy Metrics Abstract Plaque brachytherapy is the most common procedure for the treatment of small choroidal melanoma, especially in posteriorly located tumors. However, there is only little information on outcome after treatment with stereotactic radiosurgery, for example, CyberKnife radiosurgery. We reviewed patients with choroidal melanoma (maximum tumor height 4 mm) treated with CyberKnife radiosurgery. Demographic information, tumor dimension, complications, metastasis and overall survival during the whole follow-up were tracked and analyzed with a specific focus on local tumor control and potential risk factors. One hundred eighty-eight patients (102 female, 54.2%) with a median age of 63 years [interquartile range (IQR): 54–73 years] were analyzed over a median of 46 months (IQR: 24–62 months). Metastasis occurred in 14 patients (7.4%) in median of 18 months after treatment (IQR: 13–47 months) and survival was achieved in 178 patients (94.7%). Within the observation period, eye retention was observed in 166 patients (88.3%). Superior local control was achieved in patients who received a prescription dose of at least 21 Gy or more (91.6%; P = 0.04). Other potential risk factors incrementing local control were treatment planning with missing MRI in advance and too small target delineation during the planning process. Radiosurgery (CyberKnife) in a single, outpatient procedure is suitable for the treatment of small choroidal melanoma. We found local control rate after 3 years compared to the standard treatment with plaque brachytherapy. On the study side, 15 years of CyberKnife treatment allowed to identify risk factors that might increment local control and thus improve treatment regimens. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.