Anterior segment sparing to reduce charged particle radiotherapy complications in uveal melanoma

Daftari, Inder K.; Char, Devron H.; Verhey, Lynn; Castro, Joseph R.; Petti, Paula L.; Meecham, William J.; Kroll, Stewart; Blakely, Eleanor A.

doi:10.1016/s0360-3016(97)00557-9

Cited by 73 publications

(42 citation statements)

References 37 publications

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“…Local control of malignant disease is the mainstay of therapy but given excellent tumor control rates achievable, further aspects of treatment outcome gain importance: reduction of side effects and preservation of a useful vision [8,15,20,29]. The steep distal fall-off of proton-beam irradiation with typical values of about 1 mm distance from 90% to 10% isodoses for beam energies in the range of 60-90 MeV is superior to any other irradiation technique nowadays available.…”

Section: Discussionmentioning

confidence: 99%

Proton Therapy of Uveal Melanomas in Berlin

et al. 2004

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Background and Purpose:In June 1998, proton-beam therapy of ocular tumors started at the Hahn-Meitner Institute Berlin, Germany. The purpose of the present study is to evaluate treatment outcome for uveal melanomas. Patients and Methods: 245 consecutive patients with primary melanoma of the uvea were treated from June 1998 to April 2003 with a 68-MeV proton beam. In 96.2% of all patients, a uniform fractionation scheme was applied: single dose 15 CGE (cobalt gray equivalent), total dose 60 CGE on 4 consecutive days. Follow-up is available in 229 patients. Results: At the time of median follow-up (18.4 months), local control is 96.4% and 95.5% at 3 years. Eye retention rate is 92.6% at 20 months (median follow-up) and 87.5% at 3 years. Conclusion: Proton-beam irradiation of uveal melanomas at the Hahn-Meitner Institute after the first 5 years of its initiation reveals local tumor control and eye retention rates in the range of other centers with larger experience. Delivering high treatment quality in hadron therapy from the beginning has been achieved. Bestrahlung von Aderhautmelanomen mit Protonen inBerlin. 5 Jahre Behandlung am Hahn-Meitner-Institut Hintergrund und Ziel: Im Juni 1998 wurde am Hahn-Meitner-Institut in Berlin mit der Protonentherapie von Augentumoren begonnen. In der vorliegenden Arbeit werden die ersten Ergebnisse der Behandlung des primären Aderhautmelanoms vorgestellt. Patienten und Methodik: Zwischen Juni 1998 und April 2003 wurden 245 Patienten mit 68-MeV-Protonen bestrahlt. Bei 96,2% der Behandelten kam ein einheitliches Fraktionierungsschema zur Anwendung: Einzeldosis 15 CGE (Cobalt-Gray-Äquivalent), Gesamtdosis 60 CGE an 4 aufeinander folgenden Tagen. Von 229 Patienten stehen Verlaufsdaten zur Verfügung.Ergebnisse: Die lokale Tumorkontrolle liegt zum Zeitpunkt der medianen Nachbeobachtung (18,4 Monate) bei 96,4% und bei 95,5% nach 3 Jahren. Nach 3 Jahren können 87,5% der Augen erhalten werden, zum Zeitpunkt der medianen Nachbeobachtung für diesen Parameter (20 Monate) sind es 92,6%. Schlussfolgerung: Die Ergebnisse für die lokale Tumorkontrolle und den Augenerhalt sind vergleichbar mit denen anderer Zentren. Damit ist es gelungen, in der Hadronentherapie von Beginn an eine Behandlung auf hohem qualitativem Niveau zu etablieren. Schlüsselwörter: Aderhautmelanom · Protonentherapie

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Section: Discussionmentioning

confidence: 99%

Proton Therapy of Uveal Melanomas in Berlin

et al. 2004

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“…16 Some authors have reported successful prevention of neovascular glaucoma by hyper-fractionation and/or delivering smaller doses of radiation to iris and ciliary body. 17 Such results would indicate that neovascular complications can be the result of collateral damage to healthy tissues, at least in some patients.…”

Section: Miscellaneous Ocular Outcomesmentioning

confidence: 99%

Proton beam radiotherapy for uveal melanoma

Afshar

Stewart

Kao

et al. 2015

Expert Review of Ophthalmology

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Proton beam radiotherapy of uveal melanoma can be administered as primary treatment, as salvage therapy for recurrent tumor, and as neoadjuvant therapy prior to surgical resection. The physical properties of proton beams make it possible to deliver highdoses of radiation to the tumor with relative sparing of adjacent tissues. This form of therapy is effective for a wider range of uveal melanoma than any other modality, providing exceptionally-high rates of local tumor control. This is particularly the case with diffuse iris melanomas, many of which are unresectable. The chances of survival, ocular conservation, visual preservation and avoidance of iatrogenic morbidity depend greatly on the tumor size, location and extent. When treating any side-effects and/or complications, it is helpful to consider whether these are the result of collateral damage or persistence of the irradiated tumor ('toxic tumor syndrome').

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“…In recent years, conservative treatment of uveal melanoma patients has become commonplace, using either radionuclide plaques [1][2][3][4][5][6] or charged particle beams [7][8][9][10][11][12][13][14].…”

Section: Ocular Neoplasmsmentioning

confidence: 99%

“…A collaborative effort between the Radiation Oncology Department and the Ocular Oncology Unit of the University of California-San Francisco (UCSF), and the Lawrence Berkeley Laboratory, using helium ions [8,12,17], was unfortunately terminated in 1992 when the accelerator at Berkeley was shut down. Patients from UCSF are currently being treated with protons at the University of California-Davis [14].…”

Section: Munzenrider Je Proton Therapy For Eye Lesionsmentioning

confidence: 99%

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Proton therapy for uveal melanomas and other eye lesions

Munzenrider

1999

Strahlenther Onkol

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Charged particle beams are ideal for treating intra-ocular lesions, since they can be made to deposit their dose in the target, while significantly limiting dose received by non-involved ocular and orbital structures. Proton beam treatment of large numbers of uveal melanoma patients consistently achieves local control rates in excess of 95%, and eye retention rates of approximately 90%. Visual preservation is related to initial visual acuity, tumor size and location, and dose received by the macula, disc, and lens. The probability of distant metastasis is increased by larger tumor diameter, more anterior tumor location, and older patient age. Proton therapy is also effective treatment for patients with ocular angiomas, hemangiomas, metastatic tumors, and retinoblastomas, and may be beneficial for patients with exudative ("wet") age-related macular degeneration.

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Anterior segment sparing to reduce charged particle radiotherapy complications in uveal melanoma

Cited by 73 publications

References 37 publications

Proton Therapy of Uveal Melanomas in Berlin

Proton Therapy of Uveal Melanomas in Berlin

Proton beam radiotherapy for uveal melanoma

Proton therapy for uveal melanomas and other eye lesions

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