Abstract
Purpose:
To evaluate long term outcomes of proton beam radiation therapy in the treatment of large semiperipheral choroideal melanoma.
Methods:
A retrospective, nonrandomized long term follow-up of 62 patients with a tumor to disc and tumor to macular distance of more than 2 mm without previous treatment. Average tumor thickness was 7.6 mm, base 12.8 mm, fovea tumor distance 4.6 mm, disc tumor distance 5.2 mm.
Results:
The mean follow-up including eye examination was 64.4 months with a mean acquisition time of a minimum of information as to the patients’ overall survival of 67.0 months. The 5-year Kaplan-Meier estimate of average survival rate was 96.1%. Rate of enucleation was 1.7% and metastasis 13.4%. 71% of the PBRT group received endoresection of the tumor. Only 18 patients did not require additional surgery and were considered as a separate group. The most common adverse treatment effects were radiation retinopathy in both groups and radiation papillopathy in the endoresection group. Vitrectomy and cataract surgery were the most frequent secondary treatments.
Conclusions:
In large size consecutively treated tumors we demonstrate the effectiveness of proton beam irradiation to control tumor growth and preservation of the globe. This study demonstrates no higher rate of metastasis in larger tumors after treatment of proton therapy and an excellent local tumor control.
Keywords: 589 melanoma •
745 uvea •
754 visual acuity