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Salvage proton beam therapy in local recurrent uveal melanoma.
Riechardt, Aline I; Cordini, Dino; Dobner, Bianca; Seibel, Ira; Gundlach, Enken; Rehak, Matus; Hager, Annette; Stark, Roland; Moser, Lutz; Joussen, Antonia M.
Afiliación
  • Riechardt AI; Augenklinik, Charité Universitätsmedizin Berlin, Berlin, Germany. Electronic address: aline-isabel.riechardt@charite.de.
  • Cordini D; Augenklinik, Charité Universitätsmedizin Berlin, Berlin, Germany; Berlin Protonen am Helmholtz-Zentrum Berlin für Materialien und Energie, Charité Universitätsmedizin Berlin, Lise-Meitner-Campus, Berlin, Germany.
  • Dobner B; Augenklinik, Charité Universitätsmedizin Berlin, Berlin, Germany.
  • Seibel I; Augenklinik, Charité Universitätsmedizin Berlin, Berlin, Germany.
  • Gundlach E; Augenklinik, Charité Universitätsmedizin Berlin, Berlin, Germany.
  • Rehak M; Augenklinik, Charité Universitätsmedizin Berlin, Berlin, Germany.
  • Hager A; Augenklinik, Charité Universitätsmedizin Berlin, Berlin, Germany.
  • Stark R; Berlin Protonen am Helmholtz-Zentrum Berlin für Materialien und Energie, Charité Universitätsmedizin Berlin, Lise-Meitner-Campus, Berlin, Germany.
  • Moser L; Klinik für Radioonkologie und Strahlentherapie, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
  • Joussen AM; Augenklinik, Charité Universitätsmedizin Berlin, Berlin, Germany.
Am J Ophthalmol ; 158(5): 948-56, 2014 Nov.
Article en En | MEDLINE | ID: mdl-25038327
PURPOSE: To evaluate survival and ocular outcome in recurrent uveal melanoma treated with proton beam therapy as salvage therapy. DESIGN: Retrospective, interventional case series. METHODS: We evaluated 48 patients with local recurrence of uveal melanoma after primary treatment with brachytherapy, transpupillary thermotherapy, proton beam therapy, laser photocoagulation, CyberKnife radiation, or photodynamic therapy. All patients received proton beam therapy as a salvage therapy at the Helmholtz Zentrum Berlin between July 2000 and December 2010. Kaplan-Meier analysis was used to obtain survival rates. RESULTS: The Kaplan-Meier estimator for local tumor control was 92.1% at 10 years after secondary treatment with proton beam therapy. Local recurrence developed in 3 patients; 1 of them underwent enucleation. During follow-up, 20.8% of the patients died (16.7% of metastasis, 4.1% of other causes or not specified). The most frequent surgical interventions were phacoemulsification (20.8%) and pars plana vitrectomy (10.4%). The Kaplan-Meier estimators were 77.4% for survival and 70.1% for the absence of metastasis 10 years after the primary treatment. CONCLUSIONS: Proton beam therapy as a salvage treatment resulted in high local tumor control rates in recurrent uveal melanoma, especially if the primary therapy was transpupillary thermotherapy or plaque brachytherapy. Preservation of the globe was possible in most patients. Enucleations were indicated only in case of re-recurrences of uveal melanoma, but not because of secondary complications like intractable pain or secondary glaucoma. Retreatment was associated with vision deterioration, but loss of vision remained exceptional. Further larger prospective studies are needed to confirm the presented results of our retrospective analysis.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Úvea / Terapia Recuperativa / Terapia de Protones / Melanoma / Recurrencia Local de Neoplasia Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Am J Ophthalmol Año: 2014 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Úvea / Terapia Recuperativa / Terapia de Protones / Melanoma / Recurrencia Local de Neoplasia Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Am J Ophthalmol Año: 2014 Tipo del documento: Article Pais de publicación: Estados Unidos