Abstract
Aim
To present our experience of the use of stereotactic radiosurgery and proton beam therapy to treat posterior uveal melanoma over a 10 year period.
Methods and materials
Case notes of patients treated with stereotactic radiosurgery (SRS), or Proton beam therapy (PBT) for posterior uveal melanoma were reviewed. Data collected included visual acuity at presentation and final review, local control rates, globe retention and complications. We analysed post-operative visual outcomes and if visual outcomes varied with proximity to the optic nerve or fovea.
Results
191 patients were included in the study; 85 and 106 patients received Stereotactic radiosurgery and Proton beam therapy, respectively. Mean follow up period was 39 months in the SRS group and 34 months in the PBT group. Both treatments achieved excellent local control rates with eye retention in 98% of the SRS group and 95% in the PBT group. The stereotactic radiosurgery group showed a poorer visual prognosis with 65% losing more than 3 lines of Snellen acuity compared to 45% in the PBT group. 33% of the SRS group and 54% of proton beam patients had a visual acuity of 6/60 or better.
Conclusions
Stereotactic radiosurgery and proton beam therapy are effective treatments for larger choroidal melanomas or tumours unsuitable for plaque radiotherapy. Our results suggest that patients treated with proton beam therapy retain better vision post-operatively; however, possible confounding factors include age, tumour location and systemic co-morbidities. These factors as well as the patient’s preference should be considered when deciding between these two therapies.
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References
Lommatzsch PK, Werschnik C, Schuster E . Long-term follow-up of Ru-106/Rh-106 brachytherapy for posterior uveal melanoma. Graefes Arch Clin Exp Ophthalmol 2000; 238: 129–137.
Singh AD, Kivela T . The collaborative ocular melanoma study. Ophthalmol Clin North Am 2005; 18 (1): 129–142.
Gragoudas ES, Lane AM . Uveal melanoma: proton beam irradiation. Ophthalmol Clin North Am 2005; 18 (1): 111–118.
Damato B, Kacperek A, Chopra M, Campbell IR, Errington RD . Proton beam radiotherapy of choroidal melanoma: the Liverpool-Clatterbridge experience. Int J Radiat Oncol Biol Phys. 2005; 62 (5): 1405–1411.
Dinca EB, Yianni J, Rowe J, Radatz MW, Preotiuc-Pietro D, Rundle P et al. Survival and complications following γ knife radiosurgery or enucleation for ocular melanoma: a 20-year experience. Acta Neurochir (Wien) 2012; 154: 605–610.
Peyman GA, Juarez CP, Diamond JG, Raichand M . Ten years experience with eye wall resection for uveal malignant melanomas. Ophthalmology 1984; 91 (12): 1720–1725.
Oosterhuis JA, Journée-de Korver HG, Keunen JE . Transpupillary thermotherapy: results in 50 patients with choroidal melanomas. Arch Ophthalmol 1998; 116 (2): 157–162.
Rundle P . Treatment of posterior uveal melanoma with multi-dose photodynamic therapy. Br J Ophthalmol. 2014; 98 (4): 494–497.
Wackernagel W, Holl E, Tarmann L, Avian A, Schneider MR, Kapp K, Langmann G . Visual acuity after Gamma-knife radiosurgery of choroidal melanomas. Br J Ophthalmol 2013; 97: 153–158.
Gragoudas E, Li W, Goitein M, Lane AM, Munzenrider JE, Egan KM . Evidence-based estimates of outcome in patients irradiated for intraocular melanoma. Arch Ophthalmol 2002; 120: 1665–1671.
Egger E, Zografos L, Schalenbourg A, Beati D, Böhringer T, Chamot L et al. Eye retention after proton beam radiotherapy for uveal melanoma. Int J Radiat Oncol Biol Phys 2003; 55 (4): 867–880.
Wackernagel W, Holl E, Tarmann L, Mayer C, Avian A, Schneider M et al. Local tumour control and eye preservation after gamma-knife radiosurgery of choroidal melanomas. Br J Ophthalmol 2014; 98: 218–223.
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Presented as a poster at the North of England Ophthalmological Society Centenary Conference.
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Sikuade, M., Salvi, S., Rundle, P. et al. Outcomes of treatment with stereotactic radiosurgery or proton beam therapy for choroidal melanoma. Eye 29, 1194–1198 (2015). https://doi.org/10.1038/eye.2015.109
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DOI: https://doi.org/10.1038/eye.2015.109
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