BACKGROUND: Melanoma of the eye is the only potentially fatal ocular malignancy in adults. Until radiation therapy gained wide acceptance in the 1980s, enucleation was the standard treatment for the tumor. Long-term results after proton beam irradiation are now available. METHODS: We developed risk score equations to estimate probabilities of the 4 principal treatment outcomes-local tumor recurrence, death from metastasis, retention of the treated eye, and vision loss-based on an analysis of 2069 patients treated with proton beam radiation for intraocular melanoma between July 10, 1975, and December 31, 1997. Median follow-up in surviving patients was 9.4 years. RESULTS: Tumor regrowth occurred in 60 patients, and 95% of tumors (95% confidence interval, 93%-96%) were controlled locally at 15 years. Risk scores were developed for the other 3 outcomes studied. Overall, the treated eye was retained by 84% of patients (95% confidence interval, 80%-87%) at 15 years. The probabilities for vision loss (visual acuity worse than 20/200) ranged from 100% to 20% at 10 years and for death from tumor metastases from 95% to 35% at 15 years, depending on the risk group. CONCLUSIONS: High-dose radiation treatment was highly effective in achieving local control of intraocular melanomas. In most cases, the eye was salvaged, and functional vision was retained in many patients. The mortality rate was high in an identifiable subset of patients who may benefit from adjuvant therapies directed at microscopic liver metastases.
BACKGROUND:Melanoma of the eye is the only potentially fatal ocular malignancy in adults. Until radiation therapy gained wide acceptance in the 1980s, enucleation was the standard treatment for the tumor. Long-term results after proton beam irradiation are now available. METHODS: We developed risk score equations to estimate probabilities of the 4 principal treatment outcomes-local tumor recurrence, death from metastasis, retention of the treated eye, and vision loss-based on an analysis of 2069 patients treated with proton beam radiation for intraocular melanoma between July 10, 1975, and December 31, 1997. Median follow-up in surviving patients was 9.4 years. RESULTS:Tumor regrowth occurred in 60 patients, and 95% of tumors (95% confidence interval, 93%-96%) were controlled locally at 15 years. Risk scores were developed for the other 3 outcomes studied. Overall, the treated eye was retained by 84% of patients (95% confidence interval, 80%-87%) at 15 years. The probabilities for vision loss (visual acuity worse than 20/200) ranged from 100% to 20% at 10 years and for death from tumor metastases from 95% to 35% at 15 years, depending on the risk group. CONCLUSIONS: High-dose radiation treatment was highly effective in achieving local control of intraocular melanomas. In most cases, the eye was salvaged, and functional vision was retained in many patients. The mortality rate was high in an identifiable subset of patients who may benefit from adjuvant therapies directed at microscopic liver metastases.
Authors: Daniela Suesskind; Andreas Schatz; Sven Schnichels; Sarah E Coupland; Sarah L Lake; Bernd Wissinger; Karl U Bartz-Schmidt; Sigrid Henke-Fahle Journal: Graefes Arch Clin Exp Ophthalmol Date: 2011-09-01 Impact factor: 3.117
Authors: Alexandra Giatromanolaki; Efthimios Sivridis; Nikolaos E Bechrakis; Gregor Willerding; Georgios St Charitoudis; Michael H Foerster; Kevin C Gatter; Adrian L Harris; Michael I Koukourakis Journal: Clin Exp Metastasis Date: 2011-10-09 Impact factor: 5.150
Authors: Thomas Vogl; Katrin Eichler; Stephan Zangos; Christopher Herzog; Renate Hammerstingl; Jörn Balzer; Ali Gholami Journal: J Cancer Res Clin Oncol Date: 2006-10-05 Impact factor: 4.553
Authors: Geertruida E Bekkering; Anne W S Rutjes; Vasiliy V Vlassov; Daniel M Aebersold; Konrade von Bremen; Peter Jüni; Jos Kleijnen Journal: Strahlenther Onkol Date: 2009-04-16 Impact factor: 3.621