Aline I Riechardt1, Bettina Karle2, Dino Cordini1,3, Jens Heufelder1,3, Volker Budach4, Antonia M Joussen1, Johannes Gollrad5,6. 1. Department of Ophthalmology, Charité University of Medicine, Berlin, Germany. 2. Department of Radiation Oncology, Helios Klinikum Emil-von-Behring, Berlin, Germany. 3. Berlin-Protonen, Helmholtz-Zentrum Berlin, Lise-Meitner-Campus, Berlin, Germany. 4. Department of Radiation Oncology, Charité University of Medicine, Hindenburgdamm 30, 12200, Berlin, Germany. 5. Berlin-Protonen, Helmholtz-Zentrum Berlin, Lise-Meitner-Campus, Berlin, Germany. johannes.gollrad@charite.de. 6. Department of Radiation Oncology, Charité University of Medicine, Hindenburgdamm 30, 12200, Berlin, Germany. johannes.gollrad@charite.de.
Abstract
PURPOSE: The aim of this study was to evaluate local tumour control, incidence of radiation-induced glaucoma and associated interventions of sector-based and whole anterior segment proton beam therapy (PBT) for the treatment of iris melanoma. PATIENTS AND METHODS: We retrospectively analysed the data of 77 patients with iris melanoma who underwent PBT applied as 50 CGE in four daily fractions. Of the patients, 47 received PBT with a circular-shaped collimator and 30 with a conformal sector-shaped target volume. Local control, eye preservation and secondary glaucoma were evaluated. RESULTS: Median follow-up time was 54.9 months. Local tumour control was 100% in patients receiving whole anterior segment irradiation. Two patients developed pigment dispersion in the non-irradiated area after sector-based PBT and received whole anterior segment salvage PBT. The mean volume of ciliary body irradiated was 89.0% and 34.9% for whole anterior segment and lesion-based irradiation, respectively. At the end of follow-up, secondary glaucoma was found in 74.3% of the patients with whole anterior segment irradiation and in 19.2% with sector-based irradiation. Patients with sector-based PBT had a stable visual acuity of logMAR 0.1, while it declined from logMAR 0.1 to 0.4 after whole anterior segment irradiation. CONCLUSION: We found a significant reduction in radiation-induced secondary glaucoma and glaucoma-associated surgical interventions and stable visual acuity after sector-based irradiation compared with whole anterior segment irradiation. Sector-based irradiation revealed a higher risk for local recurrence, but selected patients with well-circumscribed iris melanoma benefit from applying a lesion-based target volume when treated with sector-based PBT.
PURPOSE: The aim of this study was to evaluate local tumour control, incidence of radiation-induced glaucoma and associated interventions of sector-based and whole anterior segment proton beam therapy (PBT) for the treatment of iris melanoma. PATIENTS AND METHODS: We retrospectively analysed the data of 77 patients with iris melanoma who underwent PBT applied as 50 CGE in four daily fractions. Of the patients, 47 received PBT with a circular-shaped collimator and 30 with a conformal sector-shaped target volume. Local control, eye preservation and secondary glaucoma were evaluated. RESULTS: Median follow-up time was 54.9 months. Local tumour control was 100% in patients receiving whole anterior segment irradiation. Two patients developed pigment dispersion in the non-irradiated area after sector-based PBT and received whole anterior segment salvage PBT. The mean volume of ciliary body irradiated was 89.0% and 34.9% for whole anterior segment and lesion-based irradiation, respectively. At the end of follow-up, secondary glaucoma was found in 74.3% of the patients with whole anterior segment irradiation and in 19.2% with sector-based irradiation. Patients with sector-based PBT had a stable visual acuity of logMAR 0.1, while it declined from logMAR 0.1 to 0.4 after whole anterior segment irradiation. CONCLUSION: We found a significant reduction in radiation-induced secondary glaucoma and glaucoma-associated surgical interventions and stable visual acuity after sector-based irradiation compared with whole anterior segment irradiation. Sector-based irradiation revealed a higher risk for local recurrence, but selected patients with well-circumscribed iris melanoma benefit from applying a lesion-based target volume when treated with sector-based PBT.
Authors: Bertil Damato; Andrzej Kacperek; Mona Chopra; Martin A Sheen; Ian R Campbell; R Douglas Errington Journal: Int J Radiat Oncol Biol Phys Date: 2005-09-01 Impact factor: 7.038
Authors: Jan Hrbacek; Kavita K Mishra; Andrzej Kacperek; Remi Dendale; Catherine Nauraye; Michel Auger; Joel Herault; Inder K Daftari; Alexei V Trofimov; Helen A Shih; Yen-Lin E Chen; Andrea Denker; Jens Heufelder; Tomasz Horwacik; Jan Swakoń; Cornelia Hoehr; Cheryl Duzenli; Alessia Pica; Farid Goudjil; Alejandro Mazal; Juliette Thariat; Damien C Weber Journal: Int J Radiat Oncol Biol Phys Date: 2016-01-28 Impact factor: 7.038