S93
Brachytherapy - Head & neck, skin, eye
ESTRO 2026
Proffered Paper 170 Comparative Effectiveness of Brachytherapy versus Proton Beam for Localized Uveal Melanoma: Nationwide Real-World Cohort (1995– 2018) Tamer Soror 1 , Vinodh Kakkassery 2 , Mona Kamal 3 , Ahmad Samir Alfaar 4 1 Radiation Oncology Department, University of Lübeck/UKSH-CL, Lübeck, Germany. 2 Ophthalmology Department, Hospital of Chemnitz, Chemnitz, Germany. 3 Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, USA. 4 Department of Ophthalmology, The Royal Liverpool University Hospital, Liverpool, United Kingdom Purpose/Objective: Uveal Melanoma (UM) is the most common primary intraocular malignancy in adults, affecting 5 to 7.5 per million individuals annually in the United States and Europe. Over time, treatment paradigms have shifted from primary enucleation to eye-preserving techniques such as Brachytherapy (BT) and Proton Beam Therapy (PT), each demonstrating substantial efficacy in local tumor control and disease-specific survival. This study aims to evaluate the real-world outcome of radiation therapy and impact of various demographic, clinical, and treatment variables on the survival outcomes of patients with localized UM, focusing on those treated with BT and PT. Material/Methods: Data from the North American Association of Central Cancer Registries (NAACCR) covering January 1, 1995, to December 31, 2018, were analyzed. Patients with localized UM at presentation were identified using specific ICD-O-3 site codes. The study employed survival analysis techniques including Kaplan-Meier method, Cox proportional hazards modeling, and logistic regression to examine the association between treatment modalities and survival outcomes. Results:
The cohort comprised 22,983 patients with localized disease, with 17,451 undergoing BT or PT. The study found comparable 5-year and 10-year OS and CSS rates between the BT and PT groups, with no significant differences observed. Trends in treatment utilization revealed an increase in both groups with limited increase in PT usage beyond 2004. Multivariable analysis identified age and tumor thickness as significant predictors of survival
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