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Ophthalmology. 2018 Apr;125(4):606-614. doi: 10.1016/j.ophtha.2017.10.009. Epub 2017 Nov 8.

Proton Beam Therapy for Iris Melanomas in 107 Patients.

Author information

1
Department of Radiation Oncology, Cancer Centre Francois Baclesse, Normandie Universite-Unicaen, Caen, France; Department of Radiation Oncology, Cancer Centre Antoine Lacassagne, Nice, France. Electronic address: jthariat@gmail.com.
2
Department of Ophthalmology, Croix-Rousse University Hospital, University Claude Bernard Lyon 1, Lyon, France.
3
Department of Biostatistics and Data Management, Institut de Cancerologie de Lorraine, Vandoeuvre-Les-Nancy, France.
4
Department of Ophthalmology, Ocular Oncology Center, E.O. Ospedali Galliera, Genoa, Italy.
5
Department of Ophthalmology, University Hospital Pasteur 2, Nice, France.
6
Department of Radiation Oncology, Cancer Centre Antoine Lacassagne, Nice, France.

Abstract

PURPOSE:

To report on the clinical characteristics and outcomes for patients with iris melanoma using proton therapy.

DESIGN:

Retrospective study.

PARTICIPANTS:

One hundred seven patients with iris melanoma from 3 regional ophthalmologic centers.

METHODS:

A retrospective study was conducted for iris melanoma patients from 3 regional ophthalmologic centers referred to and treated at a single proton therapy facility between 1996 and 2015.

MAIN OUTCOME MEASURES:

At each follow-up visit, examinations included measurement of best-corrected VA, slit-lamp, examination, indirect ophthalmoscopy, and ultrasound biomicroscopy.

RESULTS:

With a median follow-up of 49.5 months, 5 of 107 patients experienced a local relapse within a median of 36.3 months. The cumulative incidence of relapse was 7.5% at 5 years. All 5 patients showed involvement of the iridocorneal angle (P = 0.056). Diffuse iris melanoma showed a higher risk of relapse (P = 0.044). Four patients showed out-of-field relapse and 1 showed angular relapse. Three patients were retreated with proton therapy, whereas 2 other patients, one with T1b disease and another with diffuse T3 disease, underwent secondary enucleation. None of the patients experienced metastases nor died of iris melanoma. Vision improved in 59.4% of patients (n = 60/101). However, cataracts occurred in 57.4% of the 54 patients (n = 31) without cataract or implant at diagnosis. Secondary glaucoma was reported in 7.6% of the patients (n = 8), uveitis in 4.7% (n = 5), and hyphema in 3.7% (n = 4). All but 5 cases of complications were mild, transient, and not sight limiting after treatment. Five cases of glaucoma, including 1 with uveitis, were severe and associated with visual deterioration.

CONCLUSIONS:

Proton therapy showed efficacy and limited morbidity in iris melanomas.

PMID:
29128229
DOI:
10.1016/j.ophtha.2017.10.009
[Indexed for MEDLINE]

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