Gregor D Willerding1, Dino Cordini2, Lutz Moser3, Lothar Krause4, Michael H Foerster5, Nikolaos E Bechrakis6. 1. Department of Ophthalmology, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany Department of Ophthalmology, DRK Kliniken Westend, Berlin, Germany. 2. Department of Ophthalmology, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany Berlinprotonen at the Helmholtz-Zentrum Berlin, Lise-Meitner-Campus, Berlin, Germany. 3. Department of Radiotherapy and Radiation Oncology, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany Department of Radiotherapy, HELIOS Klinikum Emil von Behring, Berlin, Germany. 4. Department of Ophthalmology, Städtisches Klinikum, Dessau, Germany. 5. Department of Ophthalmology, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany Augenärzte Kurfürstendamm 102, Berlin, Germany. 6. Department of Ophthalmology, Medical University Innsbruck, Innsbruck, Austria.
Abstract
AIMS: To describe results after neoadjuvant proton beam irradiation followed by transscleral resection of large uveal melanoma. METHODS: Retrospective interventional case series, including 106 consecutive patients. Local tumour control, enucleation and metastasis development were assessed with survival curves. Predictors of local recurrence and metastasis were investigated with log-rank testing. RESULTS: Mean follow-up was 3.2 years. Local recurrence occurred in five cases with an estimated risk of 4.2% and 10.4% at 3 and 5 years after treatment, respectively. Enucleation was performed in 10 cases with an estimated risk of 9.2% and 18.4% at 3 and 5 years, respectively. Significant risk factors for local recurrence were not evident. Metastasis was estimated to occur in 28.4% at 3 years and 40.3% at 5 years, correlating with patient's age only (p=0.01). Seventy four patients (69.8%) underwent vitreoretinal surgery for complications after tumour resection. Median visual acuity (VA) was 20/50 at diagnosis and 20/400 in the third year after treatment. VA preservation of 20/200 or better was achieved in 33 patients (31.1%). CONCLUSION: Neoadjuvant proton beam irradiation may help to prevent local recurrence after transscleral resection. Additional vitreoretinal surgery was frequently needed in the presented series. The majority of patients avoided enucleation and functional blindness. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
AIMS: To describe results after neoadjuvant proton beam irradiation followed by transscleral resection of large uveal melanoma. METHODS: Retrospective interventional case series, including 106 consecutive patients. Local tumour control, enucleation and metastasis development were assessed with survival curves. Predictors of local recurrence and metastasis were investigated with log-rank testing. RESULTS: Mean follow-up was 3.2 years. Local recurrence occurred in five cases with an estimated risk of 4.2% and 10.4% at 3 and 5 years after treatment, respectively. Enucleation was performed in 10 cases with an estimated risk of 9.2% and 18.4% at 3 and 5 years, respectively. Significant risk factors for local recurrence were not evident. Metastasis was estimated to occur in 28.4% at 3 years and 40.3% at 5 years, correlating with patient's age only (p=0.01). Seventy four patients (69.8%) underwent vitreoretinal surgery for complications after tumour resection. Median visual acuity (VA) was 20/50 at diagnosis and 20/400 in the third year after treatment. VA preservation of 20/200 or better was achieved in 33 patients (31.1%). CONCLUSION: Neoadjuvant proton beam irradiation may help to prevent local recurrence after transscleral resection. Additional vitreoretinal surgery was frequently needed in the presented series. The majority of patients avoided enucleation and functional blindness. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Entities:
Keywords:
Choroid; Ciliary body; Retina; Treatment Surgery
Authors: Alexander Böker; Daniel Pilger; Dino Cordini; Ira Seibel; Aline I Riechardt; Antonia M Joussen; Nikolaos E Bechrakis Journal: Graefes Arch Clin Exp Ophthalmol Date: 2018-06-16 Impact factor: 3.117
Authors: Krzysztof Bilmin; Kamil J Synoradzki; Anna M Czarnecka; Mateusz J Spałek; Tamara Kujawska; Małgorzata Solnik; Piotr Merks; Mario Damiano Toro; Robert Rejdak; Michał Fiedorowicz Journal: Cancers (Basel) Date: 2021-12-28 Impact factor: 6.639