Clinical Outcomes after International Referral of Uveal Melanoma Patients for Proton Therapy.

Details

Serval ID
serval:BIB_4EF1B43F74AC
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Clinical Outcomes after International Referral of Uveal Melanoma Patients for Proton Therapy.
Journal
Cancers
Author(s)
Marinkovic M., Pors L.J., van den Berg V., Peters F.P., Schalenbourg A., Zografos L., Pica A., Hrbacek J., Van Duinen S.G., Vu THK, Bleeker J.C., Rasch CRN, Jager M.J., Luyten GPM, Horeweg N.
ISSN
2072-6694 (Print)
ISSN-L
2072-6694
Publication state
Published
Issued date
13/12/2021
Peer-reviewed
Oui
Volume
13
Number
24
Pages
6241
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
To assess oncological and ophthalmological outcomes after international referral of uveal melanoma patients for proton therapy.
This is a retrospective study among Dutch uveal melanoma patients who were treated in Switzerland with 60.0 CGE proton therapy (in 4 fractions) from 1987 to 2019. All patients were ineligible for brachytherapy due to tumour size and/or proximity to the optic nerve. Time-to-event analyses were performed using Kaplan-Meier's methodology and Cox proportional hazards models.
There were 103 patients (104 eyes) with a median largest tumour diameter of 19 mm (range 6-26 mm). Tumours were localised centrally (11%), mid-peripherally (65%) or peripherally (34%). Median follow-up was 7 years. Five-year local control, distant metastasis-free survival and eye preservation rates were 94%, 70% and 81% respectively. At five years, severe, moderate and mild visual impairment was observed in respectively 79%, 4% and 6% of the patients. Larger tumour volumes and more central tumour localisation were associated with severe visual impairment. After correction for these factors, dose to the macula, optic disc and retina, but not optic nerve was significantly associated with severe visual impairment.
International referral for proton therapy yielded good tumour control and eye preservation rates, but risk of distant metastasis and severe visual impairment were substantial, possibly due to the selection of advanced tumour stages and/or central localisation. Dose to the macula may be more relevant than dose to the optic nerve for preservation of visual acuity, which is relevant for the treatment planning of proton therapy.
Keywords
local, neoplasm recurrence, organ preservation, proton therapy, survival, uveal melanoma, visual acuity
Pubmed
Web of science
Open Access
Yes
Create date
04/01/2022 9:52
Last modification date
22/02/2022 7:35
Usage data