Proton beam radiotherapy for uveal melanoma: results of Curie Institut-Orsay proton therapy center (ICPO)

Int J Radiat Oncol Biol Phys. 2006 Jul 1;65(3):780-7. doi: 10.1016/j.ijrobp.2006.01.020. Epub 2006 May 2.

Abstract

Purpose: This study reports the results of proton beam radiotherapy based on a retrospective series of patients treated for uveal melanoma at the Orsay Center.

Methods and materials: Between September 1991 and September 2001, 1,406 patients with uveal melanoma were treated by proton beam radiotherapy. A total dose of 60 cobalt Gray equivalent (CGE) was delivered in 4 fractions on 4 days. Survival rates were determined using Kaplan-Meier estimates. Prognostic factors were determined by multivariate analysis using the Cox model.

Results: The median follow-up was 73 months (range, 24-142 months). The 5-year overall survival and metastasis-free survival rates were 79% and 80.6%, respectively. The 5-year local control rate was 96%. The 5-year enucleation for complications rate was 7.7%. Independent prognostic factors for overall survival were age (p < 0.0001), gender (p < 0.0003), tumor site (p < 0.0001), tumor thickness (p = 0.02), tumor diameter (p < 0.0001), and retinal area receiving at least 30 CGE (p = 0.003). Independent prognostic factors for metastasis-free survival were age (p = 0.0042), retinal detachment (p = 0.01), tumor site (p < 0.0001), tumor volume (p < 0.0001), local recurrence (p < 0.0001), and retinal area receiving at least 30 CGE (p = 0.002). Independent prognostic factors for local control were tumor diameter (p = 0.003) and macular area receiving at least 30 CGE (p = 0.01). Independent prognostic factors for enucleation for complications were tumor thickness (p < 0.0001) and lens volume receiving at least 30 CGE (p = 0.0002).

Conclusion: This retrospective study confirms that proton beam radiotherapy ensures an excellent local control rate. Further clinical studies are required to decrease the incidence of postirradiation ocular complications.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Disease-Free Survival
  • Dose Fractionation, Radiation
  • Eye Enucleation / statistics & numerical data
  • Female
  • Humans
  • Melanoma / mortality
  • Melanoma / radiotherapy*
  • Middle Aged
  • Neoplasm Recurrence, Local / radiotherapy
  • Neoplasm Recurrence, Local / surgery
  • Proton Therapy*
  • Retrospective Studies
  • Survival Rate
  • Uveal Neoplasms / mortality
  • Uveal Neoplasms / radiotherapy*

Substances

  • Protons