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Isolated Hepatic Perfusion as a Treatment for Liver Metastases of Uveal Melanoma
Published on: January 25, 2015
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Visual Outcomes after Proton Therapy for Recurrent Uveal Melanoma
Megan S Steinkerchner1, Caleb D Hartley1, Anne M Lane1
1Ocular Melanoma Center, Retina Service, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts.
Ophthalmology. Retina
|June 15, 2024
Summary
Proton beam re-irradiation (PBI) offers a globe-preserving option for recurrent uveal melanoma, maintaining functional vision in some patients. However, visual acuity outcomes after PBI salvage therapy can be variable.
Area of Science:
- Ophthalmology
- Radiation Oncology
- Oncology
Background:
- Uveal melanoma recurrence necessitates salvage treatment.
- Proton beam re-irradiation (PBI) is a globe-preserving alternative to enucleation for local recurrence.
- Assessing visual outcomes after PBI is crucial for treatment planning.
Purpose of the Study:
- To evaluate visual acuity (VA) outcomes after proton beam salvage therapy for recurrent uveal melanoma.
- To identify prognostic factors influencing VA after PBI.
- To determine the enucleation rate following PBI for recurrent uveal melanoma.
Main Methods:
- Retrospective study of patients with recurrent uveal melanoma treated with PBI.
- Data collected included patient and tumor characteristics, best visual acuity (BVA), and ocular outcomes.
- Multivariable Cox model used to analyze prognostic factors for VA.
Main Results:
- 67 patients with recurrent uveal melanoma received PBI.
- Median final BVA was hand motions; 9.1% maintained VA 20/40 or better.
- Worse initial VA (20/40) predicted poorer outcomes (20/200 or worse) post-PBI. 18% underwent enucleation.
Conclusions:
- Proton beam irradiation can preserve the globe and provide functional vision in select patients with recurrent uveal melanoma.
- Salvage PBI is a viable option, but visual outcomes are variable.
- Patient selection and pre-treatment visual acuity are important prognostic factors.
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