Conservation treatment of the eye: Conformal proton reirradiation for recurrent uveal melanoma

Journal Article · Wed Mar 15 04:00:00 EST 2006 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/J.IJROBP.2005.0· OSTI ID:20793377

Marucci, Laura ^[1]; Lane, Anne M ^[2]; Wenjun, Li ^[3]; Egan, Kathleen M ^[2]; Gragoudas, Evangelos S ^[2]; Adams, Judy ^[1]; Collier, John M ^[1]; Munzenrider, John E ^[1]

---

1. Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA (United States)
2. Retina Service, Massachusetts Eye and Ear Infirmary, Boston, MA (United States)
3. Biostatistics Unit, New England Medical Center, Boston, MA (United States)

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.

• OSTI ID: 20793377
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 4 Vol. 64; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
COBALT 70
EVALUATION
EYES
IRRADIATION
MELANOMAS
METASTASES
PAIN
PATIENTS
PROTON BEAMS
RADIATION DOSES
RADIOTHERAPY