Deterioration of Visual Acuity after Brachytherapy and Proton Therapy of Uveal Melanoma, and Methods of Counteracting This Complication Based on Recent Publications

Abstract

Uveal melanoma (UM) is the most common primary intraocular malignancy in adults. The eyeball is the most common extracutaneous location of melanoma. UM is a huge threat to a patient’s life. It metastasizes distantly via blood vessels, but it can also spread locally and infiltrate extraocular structures. The treatment uses surgical methods, which include, among others, enucleation and conservative methods, such as brachytherapy (BT), proton therapy (PT), stereotactic radiotherapy (SRT), stereotactic radiosurgery (SRS), transpupillary thermotherapy (TTT) and photodynamic therapy. The key advantage of radiotherapy, which is currently used in most patients, is the preservation of the eyeball with the risk of metastasis and mortality comparable to that of enucleation. Unfortunately, radiotherapy very often leads to a significant deterioration in visual acuity (VA) as a result of radiation complications. This article is a review of the latest research on ruthenium-106 (Ru-106) brachytherapy, iodine-125 (I-125) brachytherapy and proton therapy of uveal melanoma that took into account the deterioration of eye function after therapy, and also the latest studies presenting the new concepts of modifications to the applied treatments in order to reduce radiation complications and maintain better visual acuity in treated patients.

Pan-Cancer Analysis of PGAM1 and Its Experimental Validation in Uveal Melanoma Progression

“…UVM accounts for approximately 5% of all melanomas and has a high propensity to metastasize, especially to the liver [4]. The 10-year survival rate of UVM patients is only about 50%, and the median survival after metastasis detection is less than 12 months [5][6][7]. Despite advances in early diagnosis and therapeutic approaches, the prognosis of UVM remains dismal, largely due to the lack of effective treatments for metastatic disease and the poor understanding of the molecular mechanisms underlying UVM pathogenesis.…”