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[Adjuvant therapy and interdisciplinary follow-up care of conjunctival melanoma].
- Source :
-
Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft [Ophthalmologe] 2015 Nov; Vol. 112 (11), pp. 907-11. - Publication Year :
- 2015
-
Abstract
- Background: Despite microscopically controlled tumor excision, malignant melanomas of the conjunctiva have a propensity for local recurrence, lymphatic spread and distant metastases.<br />Objectives: This review outlines the options of adjuvant therapy as well as the structure of interdisciplinary follow-up care for patients with conjunctival melanoma.<br />Methods: The study provides a PubMed literature review and own clinical results.<br />Results: In conjunctival melanoma complete tumor excision using a minimal touch technique should always be combined with adjuvant therapy, such as cryotherapy, radiotherapy, topical chemotherapy and/or immunotherapy. For locally circumscribed lesions of the bulbar conjunctiva adjuvant brachytherapy can be supplemented and for non-bulbar, extensive, diffuse or multilocular tumor growth, complementary adjuvant topical mitomycin C therapy or proton radiotherapy can be used. Novel adjuvant approaches include topical interferon alpha-2b immunotherapy, topical vascular endothelial growth factor (VEGF) inhibitors or in cases of BRAF mutations personalized therapy using selective BRAF inhibitors or in combination with mitogen-activated protein kinase (MAPK) and extracellular signal-regulated kinase (ERK), MAPK/ERK (MEK) inhibitors. All patients should be integrated into an interdisciplinary follow-up care program including quarter yearly checkups in the first 5 years and psycho-oncological healthcare.<br />Conclusion: Following microscopically controlled tumor excision, adjuvant treatment using cryotherapy, radiotherapy, topical chemotherapy and/or immunotherapy as well as interdisciplinary follow-up care are mandatory for the modern management of patients with conjunctival melanoma.
- Subjects :
- Aftercare
Conjunctival Neoplasms diagnosis
Evidence-Based Medicine
Humans
Melanoma diagnosis
Patient Care Team
Treatment Outcome
Antineoplastic Agents administration & dosage
Chemoradiotherapy methods
Conjunctival Neoplasms therapy
Immunotherapy methods
Melanoma therapy
Ophthalmologic Surgical Procedures methods
Subjects
Details
- Language :
- German
- ISSN :
- 1433-0423
- Volume :
- 112
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
- Publication Type :
- Academic Journal
- Accession number :
- 26502167
- Full Text :
- https://doi.org/10.1007/s00347-015-0141-4