Conservation treatment of the eye: Conformal proton reirradiation for recurrent uveal melanoma
Department of Medicine, Division of Preventive and Behavioral Medicine
Adult; Aged; Aged, 80 and over; Confidence Intervals; Eye Enucleation; Female; Follow-Up Studies; Humans; Male; Melanoma; Middle Aged; Neoplasm Recurrence, Local; Protons; Radiotherapy, Conformal; Retrospective Studies; Treatment Outcome; Uveal Neoplasms
Eye Diseases | Neoplasms | Oncology | Radiology
PURPOSE: To evaluate the outcomes of a second course of proton beam radiation therapy (PBRT) in patients with recurrent uveal melanoma.
METHODS AND MATERIALS: Thirty-one patients received a second course of PBRT. The mean interval between the first and the second PBRT course was 50.2 months (range, 8-165 months). Most patients (87%) received 70 cobalt Gray equivalent (CGE) for both courses. Visual acuity was 20/200 or better in 30 patients initially and in 22 patients at the second treatment. The mean follow-up time after the second treatment was 50 months (range, 6-164 months).
RESULTS: At the time of the last follow-up, 20 patients were classified as having no evidence of disease, defined as tumor regression or an absence of tumor progression. Nine eyes (29%) were enucleated because of local recurrence (n = 5) or intractable pain (n = 4). The 5-year eye retention rate was 55% (95% confidence interval: 25.2-77.4). Six of the 22 patients who retained the eye (27%) had useful vision (20/200 or better).
CONCLUSIONS: A second course of PBRT for recurrent uveal melanoma to total doses between 118 and 140 CGE was associated with a relatively good probability of local control and a low enucleation rate. Although most patients lost vision, the majority were able to retain the reirradiated eye. Further evaluation is needed to assess metastasis-free survival of additional proton irradiation vs. enucleation after local recurrence.
DOI of Published Version
Marucci L, Lane AM, Li W, Egan KM, Gragoudas ES, Adams JA, Collier JM, Munzenrider JE. Conservation treatment of the eye: Conformal proton reirradiation for recurrent uveal melanoma. Int J Radiat Oncol Biol Phys. 2006 Mar 15;64(4):1018-22. Link to article on publisher's site
International journal of radiation oncology, biology, physics
Marucci, Laura; Lane, Anne Marie; Li, Wenjun; Egan, Kathleen M.; Gragoudas, Evangelos S.; Adams, Judy A.; Collier, John M.; and Munzenrider, John E., "Conservation treatment of the eye: Conformal proton reirradiation for recurrent uveal melanoma" (2006). Preventive and Behavioral Medicine Publications. 300.