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Proton Beam Irradiation: A Safe Procedure in Postequatorial Extraocular Extension From Uveal Melanoma.
- Source :
-
American journal of ophthalmology [Am J Ophthalmol] 2018 Jul; Vol. 191, pp. 49-53. Date of Electronic Publication: 2018 Apr 12. - Publication Year :
- 2018
-
Abstract
- Purpose: This study was performed to show long-term outcomes concerning metastasis rates and local recurrence rates after primary proton beam therapy in uveal melanoma with posterior extraocular extension (EOE) with the main focus on optic nerve invasion.<br />Design: Retrospective case series.<br />Methods: All patients treated with primary proton beam therapy for choroidal or ciliary body melanoma with posterior EOE between July 1998 and August 2010 were included. EOE was detected either upon sonography at primary examination or during the surgical application of tantalum clips onto the sclera. Ultrasound was performed in each patient before surgery, and if EOE was detected, a magnetic resonance imaging (MRI) scan was performed to confirm EOE. All patients with tumors exceeding 6 mm in thickness or abutting the optic disc received a 1.5 Tesla MRI scan after clip surgery. To assess EOE during follow-up, either ultrasound examinations or-if initially detected only by MRI-MRI scans were performed during follow-up.<br />Results: A total of 27 patients underwent primary proton beam therapy. The EOE was separated into 3 growth types: optic nerve infiltration in 10 patients, vortex vein infiltration in 9 patients, and transscleral growth postequatorially in 8 patients. No local recurrences were found during the overall median follow-up of 80 months (11-168 months). Metastasis rates correlated with AJCC stages but not EOE volume.<br />Conclusion: This study shows that posterior EOE can safely be treated by proton beam therapy, even if the optic nerve is infiltrated. MRI enables safe detection of optic nerve invasion.<br /> (Copyright © 2018 Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Aged
Female
Follow-Up Studies
Humans
Magnetic Resonance Imaging
Male
Melanoma diagnosis
Melanoma epidemiology
Middle Aged
Neoplasm Invasiveness
Neoplasm Staging
Optic Nerve Neoplasms epidemiology
Optic Nerve Neoplasms pathology
Retrospective Studies
Survival Rate trends
Treatment Outcome
Uveal Neoplasms diagnosis
Uveal Neoplasms epidemiology
Melanoma radiotherapy
Optic Nerve pathology
Optic Nerve Neoplasms radiotherapy
Proton Therapy methods
Uveal Neoplasms radiotherapy
Visual Acuity
Subjects
Details
- Language :
- English
- ISSN :
- 1879-1891
- Volume :
- 191
- Database :
- MEDLINE
- Journal :
- American journal of ophthalmology
- Publication Type :
- Academic Journal
- Accession number :
- 29655645
- Full Text :
- https://doi.org/10.1016/j.ajo.2018.04.006