Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jul 24;11(8):1047.
doi: 10.3390/cancers11081047.

Long-Term Visual Outcomes for Small Uveal Melanoma Staged T1 Treated by Proton Beam Radiotherapy

Adélaïde Toutée  1 , Martina Angi  2   3 , Sylvain Dureau  4 , Christine Lévy-Gabriel  2 , Livia Lumbroso-Le Rouic  2 , Rémi Dendale  5 , Laurence Desjardins  2 , Nathalie Cassoux  2   6
Affiliations

Long-Term Visual Outcomes for Small Uveal Melanoma Staged T1 Treated by Proton Beam Radiotherapy

Adélaïde Toutée et al. Cancers (Basel). .

Abstract

There is increasing evidence of the survival benefit of treating uveal melanoma in an early stage, however it is important to discuss with the patient the associated risk of visual loss. We investigated visual outcomes for uveal melanomas staged T1 (T1UM) treated by proton beam radiotherapy (PBR) as a function of their distance to fovea-optic disc. This retrospective study included a cohort of 424 patients with T1UM treated with PBR between 1991 and 2010 with at least a 5-year follow-up. Visual acuity (VA) was analyzed for patients with posterior edge of tumor located at ≥3 mm (GSup3) or <3 mm (GInf3) from fovea-optic disc. The mean follow-up duration was 122 months, no tumor recurrence was observed. The mean baseline and final VA were 20/25 and 20/32 for GSup3 (n = 75), and 20/40 and 20/80 for GInf3 (n = 317) respectively. The frequency of a 20/200 or greater visual conservation was 93.2%(CI95%:87.7-99.1) and 60.1%(CI95%:54.9-65.9) for GSup3 and GInf3 respectively. This difference between groups was statistically significant (p < 0.001). The risk factors for significant VA loss (less than 20/200) were GInf3 location (p < 0.001), tumor touching optic disc (p = 0.04), initial VA inferior to 20/40 (p < 0.001), documented growth (p = 0.002), and age greater than 60 years (p < 0.001). In summary, PBR for T1UM yields excellent tumor control and good long-term visual outcomes for tumors located ≥3 mm from fovea-optic disc.

Keywords: proton beam radiotherapy 3; staged T1 2; uveal melanoma 1.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Kaplan–Meier estimates showing the proportion of patients maintaining a visual acuity of 20/40 or better over time, among the patients with a uveal melanoma staged T1 treated by proton beam radiotherapy.
Figure 2
Figure 2
Kaplan–Meier estimates showing the proportion of patients maintaining a visual acuity of 20/200 or better over time, among the patients with a uveal melanoma staged T1 treated by proton beam radiotherapy.
Figure 3
Figure 3
Conservation of a visual acuity of 20/200 or better over time for patients with a uveal melanoma staged T1 as a function to their distance to the fovea-optic disc superior or equal to 3 mm (GSup3) or inferior to 3 mm (GInf3). Comparison using Log-Rank test (p-value < 0.001).
See this image and copyright information in PMC

References

    1. Damato B. Ocular treatment of choroidal melanoma in relation to the prevention of metastatic death A personal view. Prog. Retin. Eye Res. 2018;66:187–199. - PubMed
    1. Desjardins L., Lumbroso-Le R.L., Levy-Gabriel C., Cassoux N., Dendale R., Mazal A., Delacroix S., Sastre X., Plancher C., Asselain B. Treatment of uveal melanoma by accelerated proton beam. Dev. Ophthalmol. 2012;49:41–57. - PubMed
    1. Dendale R., Lumbroso-Le R.L., Noel G., Feuvret L., Levy C., Delacroix S., Meyer A., Nauraye C., Mazal A., Mammar H., et al. Proton beam radiotherapy for uveal melanoma: results of Curie Institut-Orsay proton therapy center (ICPO) Int. J. Radiat. Oncol. Biol. Phys. 2006;65:780–787. - PubMed
    1. Shields C.L., Sioufi K., Srinivasan A., Nicola M., Masoomian B., Barna L.E., Bekerman V.P., Say E.A.T., Mashayekhi A., Emrich J., et al. Visual Outcome and Millimeter Incremental Risk of Metastasis in 1780 Patients with Small Choroidal Melanoma Managed by Plaque Radiotherapy. JAMA Ophthalmol. 2018;136:1325–1333. - PMC - PubMed
    1. Lane A.M., Kim I.K., Gragoudas E.S. Proton irradiation for peripapillary and parapapillary melanomas. Arch. Ophthalmol. 2011;129:1127–1130. - PubMed

LinkOut - more resources