The Collaborative Ocular Melanoma Study
The University of Iowa is a participant in the Collaborative Ocular Melanoma Study (COMS), a multicernter randomized trial sponsored by The National Eye Institute and The National Cancer Institute of the National Institutes of Health.
1. Introduction
For more than 100 years, removal of the eye (enucleation) has been the standard treatment for choroidal melanoma. Before the COMS was initiated in 1986, interest in radiation therapy had increased because of the potential for saving the eye and perhaps some vision. However, the merits of radiation with respect to prolonging patient survival were unknown. The best data from nonrandomized studies suggested that there was no difference in length of remaining life between patients treated with radiation and those whose eyes were enucleated. Thus, it was appropriate and necessary to conduct a randomized, controlled clinical trial in which a large number of patients would be followed for many years in order to compare enucleation and radiation with respect to relative success in prolonging survival of choroidal melanoma patients.
The Collaborative Ocular Melanoma Study (COMS) is a set of long-term, multicenter, randomized controlled trials designed To evaluate therapeutic interventions for patients who have choroidal melanoma, the most common primary eye cancer affecting adults, and to assess the potential life-preserving as well as sight-preserving role of radiation therapy; to determine which of two standard treatments, removal of the eye or brachytherapy, is more likely to prolong survival of eligible patients with medium-sized choroidal melanoma; and to determine whether preoperative radiation prolongs life for patients whose eyes with large choroidal melanoma are enucleated.
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