Preliminary results of proton radiotherapy for choroidal melanoma in Departhment of Ophthalmology Jagiellonian University in Kraków

Abstract

Purpose Analysis of all cases choroidal melanoma treated with proton beam radiotherapy (PBRT) in 2011‐2013 in Krakow. Methods The retrospective analysis of 39 patients with choroidal melanoma treated with proton beam in Krakow in 2011‐2013 was performed. There were 20 (51%) women and 19 (49%) men in mean 53,7 years (24 ‐ 74). . The largest tumor diameter ranged from 4,6 mm to 16.2 mm, and tumor thickness from 1.4 mm to 10.3 mm. Treatment was delivered in 4 fractions on 4 consecutive days. All patients received the dose of 60 CGE (Cobalt Grey Equivalent) given to PTV (planning target volume). Results The tumour had regressed in 20 patients (51 %) and remained stable in 19 patients (49 %). The large tumours in 4 cases were removed during vitrectomy (endoresection). One tumor was excised with exoresection. In the case of 1 patient, despite intraocular tumour regression occurring the choroidal melanoma had spread multifocally into the orbit, which necessitated orbit exenteration. In this case tumor cells in scleral vessels were detected in histopathologycal examination. The results ensured that the eyeballs of 38 patients (99%) could be saved. Visual acuity improved in 5 cases, was stable in 21 and decreased in 14 patients The follow‐up period Conclusion Proton beam radiotherapy is an effective method for treating patients with choroidal melanoma. This method ensures an eyeball preservation rate of 99%, with the vision function of 67% patients being saved. Decreasing visual function was caused by choroidal melanomas location close to macula and/or optic nerve disc in our group it were in 19 (49%) cases.