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Malignant melanoma of the uvea: Radiotherapy techniques
Author(s) -
DESJARDINS L
Publication year - 2013
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.1755-3768.2013.2444.x
Subject(s) - brachytherapy , medicine , melanoma , radiation therapy , nuclear medicine , uvea , proton therapy , radiology , cancer research
Purpose Malignant melanoma of the uvea is a relatively radioresistant tumor For this reason only radiotherapy techniques with precise location of the radiation doses are used Methods Proton beam therapy has been used since 1975 by Gragoudas in Boston and the in Europe since 1983.Because of the Bragg pick, the use of an accelerated proton beam allows delivering homogenous high dose to the tumor while sparing the normal tissue around. Brachytherapy is also widely used. Iodine 125 is a low energy gamma emmeting isotope; the radiation is totally stopped by heavy metals like gold .The seeds need to be changed every two months because of its half life. Ruthenium 106 is a beta emmiting isotope. Its low penetration prevents its use for the bigger tumors. With brachytherapy the dose of 90 grays is usually delivered to the top of the tumor while the base receives more than 300grays. Results Tumor control is excellent with proton beam (less than 5% recurrence at 5 years) and good with brachytherapy (less than 10% recurrence at 5 years) Globe preservation is possible in more than 90% of treated patients