Endoresection Following Proton Beam Irradiation of Large Uveal Melanomas
Foerster M. H.1, Bechrakis N. E.1, Höcht S.2, Martus P.3, Kluge H.4
1Augenklinik, 2Strahlentherapie, 3Statistik und Epidemiologie, Universitätsklinikum Benjamin Franklin, Freie Universität Berlin; 4Hahn-Meitner Institut, Ionenstrahlenlabor, Berlin
Purpose: Large uveal melanomas have an unfavourable prognosis with regard to visual preservation and eye retention, due to the high incidence of radiation and tumour necrosis induced complications. Endoresection of tumours located close to the optic nerve and/or fovea after proton beam irradiation, is an alternative approach, aiming to reduce the incidence of ocular morbidity caused by tumour necrosis after radiotherapy alone.
Method: 32 patients with large uveal melanomas (mean tumour thickness: 9,1 mm, mean tumour volume: 0,77 cc), received a primary proton beam irradiation (60 CGE) and underwent subsequent endoresection via a 3-port pars plana vitrectomy. The median pre-treatment visual acuity was 0,2. The mean follow-up was 13,9 months.
Results: The postoperative visual acuity after 12 months was 0,12 (median , mean visual acuity loss 0,08). The probability of developing radiation retinopathy or papillopathy within the first year after treatment was 35% and 28% respectively and the probability of enucleation was 9% within the first postoperative year. No tumour recurrences were observed and two patients developed liver metastases.
Zurück | Back