gms | German Medical Science

48th Meeting of the Particle Therapy Co-Operative Group

Particle Therapy Co-Operative Group (PTCOG)

28.09. - 03.10.2009, Heidelberg

Proton radiation therapy of ocular melanoma at PSI – long term analysis

Meeting Abstract

  • G. Goitein - Paul Scherrer Instiut, Villigen, Switzerland
  • A. Schalenbourg - H˘pital Ophtalmique Jules Gonin, Lausanne, Switzerland
  • J. Verwey - Paul Scherrer Instiut, Villigen, Switzerland
  • A. Bolsi - Paul Scherrer Instiut, Villigen, Switzerland
  • C. Ares - Paul Scherrer Instiut, Villigen, Switzerland
  • L. Chamot - H˘pital Ophtalmique Jules Gonin, Lausanne, Switzerland
  • E. Hug - Paul Scherrer Instiut, Villigen, Switzerland
  • L. Zografos - H˘pital Ophtalmique Jules Gonin, Lausanne, Switzerland

PTCOG 48. Meeting of the Particle Therapy Co-Operative Group. Heidelberg, 28.09.-03.10.2009. DŘsseldorf: German Medical Science GMS Publishing House; 2009. Doc09ptcog070

DOI: 10.3205/09ptcog070, URN: urn:nbn:de:0183-09ptcog0701

Published: September 24, 2009

© 2009 Goitein et al.
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Outline

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Objective: To analyze long term treatment outcome after proton irradiation for ocular melanomas.

Materials an methods: Between March 1984 and December 2008, a total of >5076 patients with ocular lesions have been irradiated with hypo-fractionated proton radiation therapy of 4x15 Gy (RBE) at PSI in dedicated collaboration with the H˘pital Ophtalmique Lausanne. Regular clinical follow up has been done, results are analyzed for local control, survival, functional outcome and eye preservation after 5–15 years. 2993 patients with unilateral melanoma, negative familial history, visible fundus and no adjuvant chemotherapy, treated between March 1984 and August 2005 without reduced safety margin, are subject of this presentation.

Results: Overall local tumor control ( 97% @5 ys – 94% @ 15 ys) and tumor specific survival are 91% @ 5 ys – 79%@15 ys) are very satisfying. Differentiated outcome analysis shows that age, tumor size, thickness and localization have the strongest impact on local failure, enucleation rate and survival. Visual acuity after proton therapy depends on tumor localization and hight, retinal detachment, and age. Early (<2 ys) local recurrence after irradiation has significant influence on survival.

Conclusion: Ocular melanomas are the worldwide largest tumor-entity treated with proton beams. Excellent outcome data show the possible benefit of high dose, high precision proton radiotherapy; the hypo-fractionated regimen with high single doses is clinically appropriate and technically feasible in the case of ocular melanoma, without causing unacceptable toxicity.