Effects of radiotherapy on uveal melanomas and adjacent tissues.

Détails

ID Serval
serval:BIB_35590A0D2853
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Titre
Effects of radiotherapy on uveal melanomas and adjacent tissues.
Périodique
Eye
Auteur(s)
Groenewald C., Konstantinidis L., Damato B.
ISSN
1476-5454 (Electronic)
ISSN-L
0950-222X
Statut éditorial
Publié
Date de publication
02/2013
Peer-reviewed
Oui
Volume
27
Numéro
2
Pages
163-171
Langue
anglais
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Résumé
Most uveal melanomas are treated with radiotherapy. An adequate understanding of the effects of radiation on the tumour and the healthy ocular tissues is necessary. Ionizing radiation damages cell membranes, organelles, and DNA. Irradiated cells are lysed or undergo apoptosis, necrosis, and senescence. These effects occur in tumour cells and vascular endothelial cells, resulting in tumour shrinkage, ischaemia, infarction, exudation, and fibrosis, which can cause exudative maculopathy, serous retinal detachment, rubeosis, and neovascular glaucoma (ie, 'toxic tumour syndrome'). Such abnormalities must be distinguished from collateral damage to healthy ocular tissues that receive high doses of radiation, and these include radiation-induced retinopathy, optic neuropathy, choroidopathy, cataract, and scleral necrosis. Radiation retinopathy can be treated effectively with photodynamic therapy, anti-angiogenic agents, and intravitreal steroid injections. In some patients, optic neuropathy may improve with intravitreal steroids or anti-angiogenic agents. Neovascular glaucoma resolves with intra-cameral bevacizumab. Exudative retinal detachment can regress with intra-vitreal steroid injections. Cataract is treated in the usual manner. Scleral necrosis, if severe, may require grafting, possibly using a lamellar flap from the same eye. Depending on the bulk of the residual toxic tumour, treatment can consist of intra-vitreal steroids and/or anti-angiogenic agents, transpupillary thermotherapy or photodynamic therapy to the tumour, or surgical removal of the tumour by endo- or exo-resection. Measures aimed at preventing collateral damage include eccentric placement of ruthenium plaques or iodine seeds and delivery of a notched proton beam. The decision to treat a uveal melanoma with radiotherapy requires the ability to manage iatrogenic side effects and complications.
Mots-clé
Eye/radiation effects, Humans, Melanoma/radiotherapy, Organs at Risk/radiation effects, Radiation Injuries/prevention & control, Radiation Injuries/therapy, Uveal Neoplasms/radiotherapy
Pubmed
Web of science
Open Access
Oui
Création de la notice
29/08/2019 11:42
Dernière modification de la notice
03/09/2019 6:26
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