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Bull Cancer. 2018 Oct;105(10):967-980. doi: 10.1016/j.bulcan.2018.07.011. Epub 2018 Sep 11.

[Management of uveal melanomas, guidelines for oncologists].

[Article in French]

Author information

1
Hôpital de la Croix-Rousse, 103 grande rue de la Croix-Rousse, 69004 Lyon, France.
2
Institut Curie, 26, rue de l'ulm, 75248 Paris cedex 05, France.
3
Hôpital Pasteur, 30, voie romaine, 06000 Nice, France.
4
Hôpitaux civils de Colmar, 39, avenue de la liberté, 68024 Colmar, France.
5
Centre d'ophtalmologie du Zénith, 63800 Cournon D'auvergne, France.
6
CHNO des XV-XX, 28, rue de Charenton, 75012 Paris, France.
7
Centre hospitalier universitaire Pontchaillou, 2, rue Henri-Le-Guilloux, 35033 Rennes, France.
8
Polyclinique du Parc, route d'Assevent, 59600 Maubeuge, France.
9
Association nationale des patients atteints du cancer de l'œil, ANPACO, 5, rue de Fontfrède, 15230 Pierrefort, France.
10
Centre Retine Gallien, 68, rue du palais-Gallien, 33000 Bordeaux, France.
11
Centre Lacassagne, 227, avenue Valombrose, 06200 Nice, France.
12
Centre François Baclesse, ARCHADE, service de radiothérapie, 3, avenue du général-Harris, 14000 Caen, France. Electronic address: jthariat@gmail.com.

Abstract

Uveal melanomas are the most frequent primary malignant eye tumor. Enucleation was historically the gold standard. Since then, several studies showed that conservative treatments did not increase the risk of metastasis or survival. Choroidal melanomas are both radioresistant and located close to visual structures (the optic nerve and macula) of the eye, which may be preserved in some settings without compromising tumor control, as this is the first priority. Different types of radiation therapy may be used for such tumors: brachytherapy and charged particles, including proton beam therapy. If visual prognosis is dependent to the local treatment, the vital prognosis is dependent on the metastatic risk, with a risk of liver involvement in 20 to 50% of patients, depending on tumor size and genomics. Median survival after the discovery of liver metastases is about 15 months. The management of these patients is often complex. Systemic therapies (chemotherapy, targeted therapies, immunotherapy, etc.) yield limited response rates and although local treatments of liver metastases are promising, they are only feasible in selected patients. The mission of the MELACHONAT national network is to improve the management of patients regardless of the stage of the disease. The patient association ANPACO is dedicated to help uveal melanoma patients in their health care path and to promote knowledge dissemination within the patient community. The aim of this review is to focus on the local treatments of uveal melanomas as well as the management of their metastatic evolution.

KEYWORDS:

Brachytherapy; Curiethérapie; Metastasis; Mélanome oculaire; Métastase; Ocular melanoma; Proton therapy; Protonthérapie; Traitement; Treatment; Uveal; Uvéal

PMID:
30217336
DOI:
10.1016/j.bulcan.2018.07.011
[Indexed for MEDLINE]

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