Premium
Second course of proton beam therapy for recurrent uveal melanoma
Author(s) -
PAOLI V,
DELAS J,
CAUJOLLE JP
Publication year - 2012
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2012.4463.x
Subject(s) - enucleation , medicine , sclera , melanoma , surgery , visual acuity , uvea , retrospective cohort study , proton therapy , radiation therapy , eye enucleation , ophthalmology , eye disease , cancer research
Purpose To evaluate the outcomes of patients with recurrent uveal melanoma, treated by a second course of fractionated proton beam therapy (PBT) or by enucleation Methods Tumor recurrence was documented in 54 patients treated with PBT for uveal melanoma. Of these patients, 26 received a second course of PBT and 22 underwent enucleation. The mean patient age was 60,4 years (range, 27–85 years). Among patients with recurrence, the mean followup time was 5,8 years (range, 6 months–16,4 years). The mean visual acuity was 4,5/10 initially. All patients received 60 cobalt Gray equivalent for both courses. 24 recurrences occurred at the margin. The tumor regrowth was within the irradiated area in 17 patients (global recurrence), through the sclera in 4 patients (extra sclera extension), and completely outside the irradiated area in 9 patients. Results The 5‐year cumulative rate of local recurrence after the second treatment was 7,69 % (2 patients among 26 reirradiation). There had 5 enucleations (19,3%) among 26 reirradiations. A third of reirradiated patients maintained useful vision after a second course of PBT : 39% had 20/200 vision or better after the second treatment. The Kaplan‐Meier overall survival rate is better with Proton Beam Therapy (PBT) VS Enucleation ( p<0,02) Conclusion A second course of PBRT for recurrent uveal melanoma was associated with a relatively good probability of local control and a low enucleation rate. This retrospective analysis suggests that survival in reirradiated patients is not compromised by administration of a second course of PBT for recurrent uveal melanoma.