RT Journal Article
SR Electronic
T1 Predictive factors for the development of rubeosis following proton beam radiotherapy for uveal melanoma
JF British Journal of Ophthalmology
JO Br J Ophthalmol
FD BMJ Publishing Group Ltd.
SP 748
OP 754
DO 10.1136/bjo.81.9.748
VO 81
IS 9
A1 Alexander J E Foss
A1 Irene Whelehan
A1 John L Hungerford
A1 David F Anderson
A1 R Douglas Errington
A1 Andrzej Kacperek
A1 Marie Restori
A1 Jane Kongerud
A1 Martin Sheen
YR 1997
UL http://bjo.bmj.com/content/81/9/748.abstract
AB AIMS/BACKGROUND Proton beam radiotherapy can effectively treat primary uveal melanomas of any size. Some patients, however, develop adverse late effects following treatment and the purpose of this study was to determine which factors give rise to a poor local outcome. METHODS The hospital records from a first cohort of 127 patients treated by protons from 1989 to 1992 were reviewed retrospectively. The presence of rubeosis was selected as a measure of significant ocular damage. Split file analysis was performed with 73 cases forming a test group with the remaining 54 cases acting as a validation group. RESULTS Large tumour size and the presence of retinal detachment were significant, independent risk factors for developing rubeosis for both the test and validation groups. These factors also predicted subsequent enucleation for uncontrolled ocular pain. Patients with tumours too large to plaque and with an associated retinal detachment had a 90% chance of developing rubeosis within 4 years of proton beam radiotherapy. CONCLUSIONS Patients with a uveal melanoma too large for plaque therapy and an associated retinal detachment run a very high risk of developing rubeosis after proton beam radiotherapy and one third of individuals developing rubeosis required enucleation for pain even if local tumour control was satisfactory.