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Correspondence
May 2002

The COMS: Why Was It Not Stopped Sooner?

Arch Ophthalmol. 2002;120(5):673. doi:

In reply

Thank you for the opportunity to respond to Dr Benson's letter regarding the COMS randomized trial of iodine 125 brachytherapy vs enucleation, from which findings were published in the ARCHIVES last year.1 Most of the issues raised by Dr Benson are those set forth in his 1986 letter2; a response from one of us (S.L.F) was published simultaneously.3 Through the 1970s, enucleation of eyes was the standard treatment for choroidal melanoma. By the 1980s, sufficient experience had been gained with radiotherapy approaches designed to preserve the eye that the majority of the ophthalmologic community deemed it important to conduct a randomized trial that enrolled a sufficient number of patients and followed them long enough to compare the mortality rates with radiotherapy vs enucleation. The proposed design and methods of the COMS underwent peer review at the National Institutes of Health, Bethesda, Md, and the study was recommended for funding. The National Eye Institute, Bethesda, later joined by the National Cancer Institute, sponsored the COMS. Many respected ophthalmologists from the United States and Canada who had significant experience treating patients with choroidal melanoma have participated in the COMS.1

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