Uveal melanoma: development of metastases after helium ion irradiation.

Abstract

Forty-two (16%) of 261 patients with ocular melanoma who were treated with helium ions between January 1978 and November 1986 have developed metastatic disease. The time between start of helium ion treatment and recognition of metastatic disease ranged from 3 to 67 months (median, 27 months). The mean pretreatment tumor height in the patients with metastases was 7.7 mm. All 42 patients who developed metastatic disease have died. The median survival after diagnosis of metastatic disease was 5 months; the longest survival was 49 months. The most common site of metastasis was the liver (n = 34). Four (10%) of the 42 patients with metastases also had local recurrence of the tumor. Multivariate analysis identified three variables that predicted independently the development of metastases and lack of survival. These variables are anterior location of tumor (P = .027), tumor height greater than 5 mm (P = .02), and tumor diameter greater than 10 mm (P = .0075).

Neutrons from fragmentation of light nuclei in tissue-like media: a study with the GEANT4 toolkit

“…In the seventies alphaparticles (Castro et al 1997, Nowakowski et al 1991 and neon ions , Castro et al 1994 were first used for patient treatments. In the last ten years remarkable results were obtained in cancer therapy with carbon ions at the Gesellschaft für Schwerionenforschung GSI (Schulz-Ertner et al 2004, Krämer et al as explained by Gudowska et al (2004), SHIELD-HIT code is currently under further development and it is not available to the general user.…”

“…Only a few decades after Wilson's proposal, in the sixties, advancements in accelerator techniques have made possible the widespread use of proton beams for therapeutic purposes (Archambeau et al 1974, Orecchia et al 1998. In the seventies, helium ions (Castro et al 1997, Nowakowski et al 1991 and neon ions (Linstadt et al 1991, Castro et al 1994 were first used for patient treatments. In the last ten years, remarkable results were obtained in cancer therapy with carbon ions at the Gesellschaft für Schwerionenforschung GSI (Schulz-Ertner et al 2004, Krämer et al 2003 in Germany, and at the National Institute of Radiological Sciences at the HIMAC facility (Tsujii et al 2004) in Chiba, Japan.…”

Lauriston S. Taylor Lecture on Radiation Protection and Measurements

“…Precise helium high-dose radiotherapy of uveal melanoma eradicated 97% of the tumors with the patients retaining their eyes with vision (Linstadt et al 1988), and few surrounding tissue toxicities (e.g., neovascular glaucoma) (Linstadt et al 1990). Only patients with large anterior lesions developed late-appearing metastases, primarily to the liver (Nowakowski et al 1991). The brain behind the eye received virtually no radiation dose, something difficult to accomplish with conventional radiotherapy, but most of the patients developed a radiation-induced cataract since the dose to the retinal tumor was delivered through the crystalline lens (Meecham et al 1994).…”

High-Let Charged Particle Radiotherapy

“…Experience at UCLBL/UCSF with helium ion therapy has successfully demonstrated the advantage of charged particle doselocalization therapy in treating tumors in the eye, orbit, skull base, paranasal sinuses, juxtaspinal area, retroperitoneal space and soft tissue with high rates of local control and survival (8,9,10,11).…”