Proton beam therapy for presumed and confirmed iris melanomas: a review of 36 cases

Rahmi, Ahmed; Mammar, Hamid; Thariat, Juliette; Angellier, G.; Hérault, J.; Chauvel, Patrick; Kodjikian, Laurent; Denis, Philippe; Grangé, J.D.

doi:10.1007/s00417-014-2735-y

Cited by 17 publications

(7 citation statements)

References 26 publications

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“…Tumor with extrascleral extension ≥ 5 mm in diameter a Source: Edge et al 51 extensive tumor seeding and in non-resectable iris tumors, achieving melanoma control in 92% of cases. 49,54,55 (Figure 1). However, vision loss is a worrisome adverse effect of this treatment.…”

Section: T4 Tumor With Extrascleral Extension T4amentioning

confidence: 99%

Uveal melanoma: relatively rare but deadly cancer

Kaliki

Shields

2016

Eye

471

533

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Although it is a relatively rare disease, primarily found in the Caucasian population, uveal melanoma is the most common primary intraocular tumor in adults with a mean age-adjusted incidence of 5.1 cases per million per year. Tumors are located either in iris (4%), ciliary body (6%), or choroid (90%). The host susceptibility factors for uveal melanoma include fair skin, light eye color, inability to tan, ocular or oculodermal melanocytosis, cutaneous or iris or choroidal nevus, and BRCA1-associated protein 1 mutation. Currently, the most widely used first-line treatment options for this malignancy are resection, radiation therapy, and enucleation. There are two main types of radiation therapy: plaque brachytherapy (iodine-125, ruthenium-106, or palladium-103, or cobalt-60) and teletherapy (proton beam, helium ion, or stereotactic radiosurgery using cyber knife, gamma knife, or linear accelerator). The alternative to radiation is enucleation. Although these therapies achieve satisfactory local disease control, long-term survival rate for patients with uveal melanoma remains guarded, with risk for liver metastasis. There have been advances in early diagnosis over the past few years, and with the hope survival rates could improve as smaller tumors are treated. As in many other cancer indications, both early detection and early treatment could be critical for a positive long-term survival outcome in uveal melanoma. These observations call attention to an unmet medical need for the early treatment of small melanocytic lesions or small melanomas in the eye to achieve local disease control and vision preservation with the possibility to prevent metastases and improve overall patient survival.

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Section: T4 Tumor With Extrascleral Extension T4amentioning

confidence: 99%

Uveal melanoma: relatively rare but deadly cancer

Kaliki

Shields

2016

Eye

471

533

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“…Currently, the management of surgical options mainly depends on tumor location, extent, and size, adverse effects, and systemic status, including partial iridectomy, iridotrabeculectomy of the iris, and iridocyclectomy ( Henderson and Margo, 2008 ). Radiotherapy can also achieve high local control in most cases with extensive seeding and in non-resectable tumors ( Shields et al, 2013 ; Rahmi et al, 2014 ). However, approximately 50% of patients develop metastatic disease, predominantly in the liver, which is refractory to traditional treatments such as chemotherapy and surgical metastasectomy ( Achberger et al, 2014 ).…”

Section: Introductionmentioning

confidence: 99%

Analysis of Ferroptosis-Mediated Modification Patterns and Tumor Immune Microenvironment Characterization in Uveal Melanoma

Jin

Wang

et al. 2021

Front. Cell Dev. Biol.

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Uveal melanoma (UVM) is an intraocular malignancy in adults in which approximately 50% of patients develop metastatic disease and have a poor prognosis. The need for immunotherapies has rapidly emerged, and recent research has yielded impressive results. Emerging evidence has implicated ferroptosis as a novel type of cell death that may mediate tumor-infiltrating immune cells to influence anticancer immunity. In this study, we first selected 11 ferroptosis regulators in UVM samples from the training set (TCGA and GSE84976 databases) by Cox analysis. We then divided these molecules into modules A and B based on the STRING database and used consensus clustering analysis to classify genes in both modules. According to the Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and Gene Set Enrichment Analysis (GSEA), the results revealed that the clusters in module A were remarkably related to immune-related pathways. Next, we applied the ESTIMATE and CIBERSORT algorithms and found that these ferroptosis-related patterns may affect a proportion of TME infiltrating cells, thereby mediating the tumor immune environment. Additionally, to further develop the prognostic signatures based on the immune landscape, we established a six-gene-regulator prognostic model in the training set and successfully verified it in the validation set (GSE44295 and GSE27831). Subsequently, we identified the key molecules, including ABCC1, CHAC1, and GSS, which were associated with poor overall survival, progression-free survival, disease-specific survival, and progression-free interval. We constructed a competing endogenous RNA network to further elucidate the mechanisms, which consisted of 29 lncRNAs, 12 miRNAs, and 25 ferroptosis-related mRNAs. Our findings indicate that the ferroptosis-related genes may be suitable potential biomarkers to provide novel insights into UVM prognosis and decipher the underlying mechanisms in tumor microenvironment characterization.

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“…The main treatment option for iris melanoma is brachytherapy and many reports on radiotherapy are available. Among these, brachytherapy 14,19,20 and proton beam therapy (PBT) 13,21,22 are the most frequently evaluated treatment approaches. Less can be found on surgical resection 18,23 .…”

Section: Discussionmentioning

confidence: 99%

Robotic assisted CyberKnife radiosurgery for the treatment of iris melanoma

Schmelter

Heidorn²,

Muacevic³

et al. 2021

Sci Rep

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Iris melanoma is a rare form of uveal melanoma with potential metastic spread. Treatment options include surgical resection, enucleation or irradiation. We analysed visual outcome, complication appearance and management in eight patients with iris melanoma following robotic-assisted CyberKnife treatment. Consecutive patients from the Department of Ophthalmology at University of Munich were included in the study if they had an iris melanoma that was treated with CyberKnife and had a minimum follow-up of 12 months. We evaluated tumor thickness, largest diameter, visual acuity and complications. 8 patients were included in this report. The median age was 74 years (range: 53–86 years). The median follow-up was 23 months (range 12–48 months). Tumor thickness decreased from 2.1 to 1.4 mm on average. Four out of eight patients showed stable or increased visual acuity compared to visual acuity at first visit. We did not find a correlation of applied radiation volume or radiation dose on visual outcome. Radiation keratopathy was the most common complication in five patients. No recurrences were noted. Robotic-assisted radiosurgery following CyberKnife is a promising non-invasive, single session treatment option for iris melanoma with comparable results regarding recurrence rate or complications to brachytherapy and proton beam therapy. All included patients showed good visual outcome.

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Proton beam therapy for presumed and confirmed iris melanomas: a review of 36 cases

Abstract: Proton beam therapy appears to be the treatment of choice for the conservative treatment of iris melanomas with excellent tumor control and an acceptable rate of complications. Longer follow-up studies on a larger series is necessary to consolidate these results.

Cited by 17 publications

References 26 publications

Uveal melanoma: relatively rare but deadly cancer

Uveal melanoma: relatively rare but deadly cancer

Analysis of Ferroptosis-Mediated Modification Patterns and Tumor Immune Microenvironment Characterization in Uveal Melanoma

Robotic assisted CyberKnife radiosurgery for the treatment of iris melanoma

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