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Proton Beam Irradiation of Uveal Melanomas: Results of 5½-Year Study

Proton Beam Irradiation of Uveal Melanomas: Results of 5½-Year Study Abstract • Proton beam irradiation was used in the treatment of 76 uveal melanomas from July 1975 to December 1980. Five (7%) were small, 32 (42%) were medium, and 39 (51%) were large melanomas. The follow-up period ranged from two months to 5½ years; 19 patients were followed up for more than two years and 39 were observed for more than a year. Tumor regression has been achieved in all eyes with more than 12 months of follow-up except one, which was enucleated because of secondary complications. Three patients in whom metastatic disease developed died. Our data indicate that proton irradiation can be used for the treatment of relatively large lesions that previously were considered untreatable and reduces the high ocular morbidity experienced with other methods in the treatment of medium and small melanomas. References 1. Gragoudas ES, Goitein M, Koehler AM, et al: Proton irradiation of small choroidal malignant melanomas . Am J Ophthalmol 1977;83:665-673. 2. Gragoudas ES, Goitein M, Koehler AM, et al: Proton irradiation of choroidal melanomas: Preliminary results . Arch Ophthalmol 1978;96:1583-1591.Crossref 3. Gragoudas ES, Goitein M, Koehler A, et al: Proton irradiation of malignant melanoma of the ciliary body . Br J Ophthalmol 1979;63:135-139.Crossref 4. Gragoudas ES, Goitein M, Verhey L, et al: Proton beam irradiation: An alternative to enucleation for intraocular melanomas . Ophthalmology 1980;87:571-581.Crossref 5. Warren RM: Prognosis of malignant melanomas of the choroid and ciliary body , in Blodi FC (ed): Current Concepts in Ophthalmology . St Louis, CV Mosby Co, 1974, vol 4, pp 158-167. 6. Vogel MH: Treatment of malignant choroidal melanomas with photocoagulation: Evaluation of a ten year follow-up data . Am J Ophthalmol 1972;74:1-11. 7. Meyer-Schwickerath G, Vogel M: Treatment of malignant melanomas of the choroid by photocoagulation . Trans Ophthalmol Soc UK 1977;97:416-420. 8. Peyman GA, Raichand M: Full-thickness eye wall resection of choroidal neoplasms . Ophthalmology 1979;86:1024-1036.Crossref 9. MacFaul PA: Local radiotherapy in the treatment of malignant melanoma of the choroid . Trans Ophthalmol Soc UK 1977;97:421-427. 10. Char DH, Lonn LJ, Margolis LW: Complications of cobalt plaque therapy of choroidal melanomas . Am J Ophthalmol 1977;84:536-541. 11. Davidorf FH, Makley TA, Lang JR: Radiotherapy of malignant melanoma of the choroid . Trans Am Acad Ophthalmol Otolaryngol 1976;81:849-861. 12. Zinn KM, Pokorny KS, Jakobiec FA, et al: Proton-beam irradiated epithelioid cell melanoma of the ciliary body . Ophthalmology 1981;88:1315-1321.Crossref 13. Gragoudas ES, Zakow NZ, Albert DM, et al: Long-term observations of proton-irradiated monkey eyes . Arch Ophthalmol 1979;97:2184-2191.Crossref 14. McLean JW, Foster WD, Zimmerman LE: Prognostic factors in small malignant melanomas of choroid and ciliary body . Arch Ophthalmol 1977;95:48-58.Crossref 15. Shammas HF, Blodi FC: Prognostic factors in choroidal and ciliary body melanomas . Arch Ophthalmol 1977;95:63-69.Crossref 16. Zimmerman LE, McLean IW, Foster WD: Statistical analysis of follow-up data concerning uveal melanomas, and the influence of enucleation . Ophthalmology 1980;87:557-564.Crossref 17. Paul EV, Parnell BL, Fraker M: Prognosis of malignant melanomas of the choroid and ciliary body . Int Ophthalmol Clin 1962;2:387-402.Crossref 18. Seigel D, Myers M, Ferris F III, et al: Survival rates after enucleation of eyes with malignant melanoma . Am J Ophthalmol 1979;87:761-765. 19. Shammas HF, Blodi FC: Orbital extension of choroidal and ciliary body melanomas . Arch Ophthalmol 1977;95:2002-2005.Crossref 20. Gass JDM: Observation of suspected choroidal and ciliary body melanomas for evidence of growth prior to enucleation . Ophthalmology 1980;87:523-528.Crossref 21. Apple DJ, Blodi FC: Uveal melanocytic tumors: A grouping according to phases of growth and prognosis with comments on current theories of nonenucleation treatment . Int Ophthalmol Clin 1979;20:33-61. 22. Zimmerman LE, McLean IW, Foster WD: Does enucleation of the eye containing a malignant melanoma prevent or accelerate the dissemination of tumor cells? Br J Ophthalmol 1978;62:420-425.Crossref 23. Zimmerman LE, McLean IW: An evaluation of enucleation in the management of uveal melanomas . Am J Ophthalmol 1979;87:741-760. 24. Albert D: Toward resolving the ocular melanomas controversy . Arch Ophthalmol 1979;97:451-452.Crossref 25. Jakobiec FA: A moratorium on enucleation for choroidal melanoma . Am J Ophthalmol 1979;87:842-846. 26. Boniuk M: A crisis in the management of patients with choroidal melanoma . Am J Ophthalmol 1979;87:840-842. 27. Davidorf FH: Treatment of malignant melanomas . Arch Ophthalmol 1979;97:975-976.Crossref 28. Manschot WA, van Peperzeel HA: Choroidal melanoma: Enucleation or observation? A new approach . Arch Ophthalmol 1980;98:71-77.Crossref 29. Gass JDM: Changing concepts of natural course and management of uveal melanomas , in Nicholson DH (ed): Ocular Pathology Update . New York, Masson Publishing USA Inc, 1980, pp 227-234. 30. Apple DJ, Blodi FC: Pathological observations and clinical approach to uveal melanoma , in Nicholson DH (ed): Ocular Pathology Update . New York, Masson Publishing USA Inc, 1980, pp 213-226. 31. Char DH, Castro JR, Quivey JM, et al: Helium ion charged particle therapy for choroidal melanoma . Ophthalmology 1980;87:565-570.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1982 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1982.01030030936007
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Abstract

Abstract • Proton beam irradiation was used in the treatment of 76 uveal melanomas from July 1975 to December 1980. Five (7%) were small, 32 (42%) were medium, and 39 (51%) were large melanomas. The follow-up period ranged from two months to 5½ years; 19 patients were followed up for more than two years and 39 were observed for more than a year. Tumor regression has been achieved in all eyes with more than 12 months of follow-up except one, which was enucleated because of secondary complications. Three patients in whom metastatic disease developed died. Our data indicate that proton irradiation can be used for the treatment of relatively large lesions that previously were considered untreatable and reduces the high ocular morbidity experienced with other methods in the treatment of medium and small melanomas. References 1. Gragoudas ES, Goitein M, Koehler AM, et al: Proton irradiation of small choroidal malignant melanomas . Am J Ophthalmol 1977;83:665-673. 2. Gragoudas ES, Goitein M, Koehler AM, et al: Proton irradiation of choroidal melanomas: Preliminary results . Arch Ophthalmol 1978;96:1583-1591.Crossref 3. Gragoudas ES, Goitein M, Koehler A, et al: Proton irradiation of malignant melanoma of the ciliary body . Br J Ophthalmol 1979;63:135-139.Crossref 4. Gragoudas ES, Goitein M, Verhey L, et al: Proton beam irradiation: An alternative to enucleation for intraocular melanomas . Ophthalmology 1980;87:571-581.Crossref 5. Warren RM: Prognosis of malignant melanomas of the choroid and ciliary body , in Blodi FC (ed): Current Concepts in Ophthalmology . St Louis, CV Mosby Co, 1974, vol 4, pp 158-167. 6. Vogel MH: Treatment of malignant choroidal melanomas with photocoagulation: Evaluation of a ten year follow-up data . Am J Ophthalmol 1972;74:1-11. 7. Meyer-Schwickerath G, Vogel M: Treatment of malignant melanomas of the choroid by photocoagulation . Trans Ophthalmol Soc UK 1977;97:416-420. 8. Peyman GA, Raichand M: Full-thickness eye wall resection of choroidal neoplasms . Ophthalmology 1979;86:1024-1036.Crossref 9. MacFaul PA: Local radiotherapy in the treatment of malignant melanoma of the choroid . Trans Ophthalmol Soc UK 1977;97:421-427. 10. Char DH, Lonn LJ, Margolis LW: Complications of cobalt plaque therapy of choroidal melanomas . Am J Ophthalmol 1977;84:536-541. 11. Davidorf FH, Makley TA, Lang JR: Radiotherapy of malignant melanoma of the choroid . Trans Am Acad Ophthalmol Otolaryngol 1976;81:849-861. 12. Zinn KM, Pokorny KS, Jakobiec FA, et al: Proton-beam irradiated epithelioid cell melanoma of the ciliary body . Ophthalmology 1981;88:1315-1321.Crossref 13. Gragoudas ES, Zakow NZ, Albert DM, et al: Long-term observations of proton-irradiated monkey eyes . Arch Ophthalmol 1979;97:2184-2191.Crossref 14. McLean JW, Foster WD, Zimmerman LE: Prognostic factors in small malignant melanomas of choroid and ciliary body . Arch Ophthalmol 1977;95:48-58.Crossref 15. Shammas HF, Blodi FC: Prognostic factors in choroidal and ciliary body melanomas . Arch Ophthalmol 1977;95:63-69.Crossref 16. Zimmerman LE, McLean IW, Foster WD: Statistical analysis of follow-up data concerning uveal melanomas, and the influence of enucleation . Ophthalmology 1980;87:557-564.Crossref 17. Paul EV, Parnell BL, Fraker M: Prognosis of malignant melanomas of the choroid and ciliary body . Int Ophthalmol Clin 1962;2:387-402.Crossref 18. Seigel D, Myers M, Ferris F III, et al: Survival rates after enucleation of eyes with malignant melanoma . Am J Ophthalmol 1979;87:761-765. 19. Shammas HF, Blodi FC: Orbital extension of choroidal and ciliary body melanomas . Arch Ophthalmol 1977;95:2002-2005.Crossref 20. Gass JDM: Observation of suspected choroidal and ciliary body melanomas for evidence of growth prior to enucleation . Ophthalmology 1980;87:523-528.Crossref 21. Apple DJ, Blodi FC: Uveal melanocytic tumors: A grouping according to phases of growth and prognosis with comments on current theories of nonenucleation treatment . Int Ophthalmol Clin 1979;20:33-61. 22. Zimmerman LE, McLean IW, Foster WD: Does enucleation of the eye containing a malignant melanoma prevent or accelerate the dissemination of tumor cells? Br J Ophthalmol 1978;62:420-425.Crossref 23. Zimmerman LE, McLean IW: An evaluation of enucleation in the management of uveal melanomas . Am J Ophthalmol 1979;87:741-760. 24. Albert D: Toward resolving the ocular melanomas controversy . Arch Ophthalmol 1979;97:451-452.Crossref 25. Jakobiec FA: A moratorium on enucleation for choroidal melanoma . Am J Ophthalmol 1979;87:842-846. 26. Boniuk M: A crisis in the management of patients with choroidal melanoma . Am J Ophthalmol 1979;87:840-842. 27. Davidorf FH: Treatment of malignant melanomas . Arch Ophthalmol 1979;97:975-976.Crossref 28. Manschot WA, van Peperzeel HA: Choroidal melanoma: Enucleation or observation? A new approach . Arch Ophthalmol 1980;98:71-77.Crossref 29. Gass JDM: Changing concepts of natural course and management of uveal melanomas , in Nicholson DH (ed): Ocular Pathology Update . New York, Masson Publishing USA Inc, 1980, pp 227-234. 30. Apple DJ, Blodi FC: Pathological observations and clinical approach to uveal melanoma , in Nicholson DH (ed): Ocular Pathology Update . New York, Masson Publishing USA Inc, 1980, pp 213-226. 31. Char DH, Castro JR, Quivey JM, et al: Helium ion charged particle therapy for choroidal melanoma . Ophthalmology 1980;87:565-570.Crossref

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Jun 1, 1982

References