Effects of radiotherapy on uveal melanomas and adjacent tissues

Groenewald, Carl; Konstantinidis, Lazaros; Damato, Bertil

doi:10.1038/eye.2012.249

Cited by 111 publications

(113 citation statements)

References 53 publications

(45 reference statements)

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“…'toxic tumour syndrome') [2] . These risks were higher with the anterior location of the tumour [2,3] making also the scleral necrosis more probable [3] . Cyclochoroidectomy would have risked hypotony and retinal detachment [4] .…”

Section: Discussionmentioning

confidence: 99%

Core Endoresection as Neoadjuvant Treatment of Uveal Melanoma

et al. 2015

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Aim: To present a case of neoadjuvant treatment of uveal melanoma with a limited core endoresection, which enabled ruthenium plaque radiotherapy to be administered. Material and Methods: A 77-year-old woman presented in 2005 with a ciliochoroidal uveal melanoma measuring 7.2 by 6.5 mm basally with a thickness of 6.2 mm. The vision in the affected eye was 6/9. Because of diagnostic uncertainty, we performed a biopsy, which produced a copious sample. The biopsy serendipitously reduced the tumour thickness to 4.4 mm, making ruthenium plaque brachytherapy possible. Results: Histopathological examination showed the tumour to be a melanoma predominantly of spindle cell type. Postoperative complications included a dense vitreous haemorrhage, which cleared spontaneously, and raised intraocular pressure, controlled with latanoprost. Seven years after brachytherapy, the vision was 6/5 and the thickness of the residual tumour was 2.5 mm. Nine years after treatment, there was no evidence of any intra- or extraocular seeding or distant metastases. Conclusions: Core endoresection of a ciliochoroidal melanoma may reduce tumour thickness enough to allow subsequent ruthenium plaque radiotherapy.

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Section: Discussionmentioning

confidence: 99%

Core Endoresection as Neoadjuvant Treatment of Uveal Melanoma

et al. 2015

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“…After irradiation, tumor cells and vascular cells undergo apoptosis or necrosis resulting in exudation and inflammation [19]. Thus, after vitrectomy only, one would have expected more cases presenting with retinal redetachments as neither vitrectomy itself nor tamponade with silicone oil does influence the exudative activity of the tumor.…”

Section: Discussionmentioning

confidence: 99%

Endodrainage, Tumor Photocoagulation, and Silicone Oil Tamponade for Primary Exudative Retinal Detachment due to Choroidal Melanoma Persisting after Proton Beam Therapy

et al. 2014

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Background: Choroidal melanoma is frequently accompanied by an exudative retinal detachment that can persist after proton beam therapy. This study investigates whether vitrectomy without tumor resection improves the clinical outcome. Methods: This is a retrospective interventional case series. Twenty patients with choroidal melanoma with exudative retinal detachment involving the macula were treated by vitrectomy, endodrainage, photocoagulation, and silicone oil tamponade after proton beam therapy. Results: The mean follow-up was 38.4 months (median 21.5, range 12.0-122.0). The mean time between proton beam therapy and surgery was 4.5 months (range 0.1-9.2). Reattachment was achieved in 95% of the patients after one vitrectomy. One patient was lost to follow-up because enucleation was performed after 45.9 months due to a secondary glaucoma. Mean visual acuity decreased from 1.1 to 1.8 logMAR before vitrectomy and after 4 years, respectively. No patient showed local tumor recurrence. Metastatic disease was present in 1 patient after 15.2 months, and this patient died after 19.2 months. Conclusion: Vitrectomy is indicated after therapeutic proton beam irradiation in patients who present with persisting exudative retinal detachment involving the macula and high local or systemic risk factors for hemorrhagic complications, thus excluding endoresection.

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“…15,16 We prefer proton beam radiotherapy unless this is expected to cause canalicular damage, that is, if the tumour is medial and extends far posteriorly.…”

Section: Figurementioning

confidence: 99%