gms | German Medical Science

25th Annual Meeting of the German Retina Society

German Retina Society

01.06. - 02.06.2012, Münster

Comparison of episcleral plaque therapy and proton beam radiation therapy for the treatment of choroidal melanoma – a long-term follow-up

Meeting Abstract

  • Antonia M. Joussen - Augenklinik der Charité Berlin
  • D. Cordini - Klinik für Strahlentherapie, Helmholzzentrum Berlin
  • G. Willerding - Augenklinik der Charité Berlin
  • J. Heufelder - Augenklinik der Charité Berlin
  • N. Lakotka - Augenklinik der Charité Berlin
  • A.I. Riechardt - Augenklinik der Charité Berlin
  • L. Moser - Klinik für Strahlentherapie, Helmholzzentrum Berlin

German Retina Society. 25th Annual Conference of the German Retina Society. Münster, 01.-02.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. Doc12rg22

doi: 10.3205/12rg22, urn:nbn:de:0183-12rg228

This is the translated version of the article.
The original version can be found at: http://www.egms.de/de/meetings/rg2012/12rg22.shtml

Published: May 30, 2012

© 2012 Joussen et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Purpose: to compare the efficacy of episcleral plaque therapy with ruthenium-106 (Ru-106) and proton beam radiation therapy (PBRT) in the treatment of choroidal melanoma.

Design and methods: A retrospective, nonrandomized follow-up of patients with choroidal melanoma. Melanomas with a tumor to disc and tumor to macular distance of more than 2 mm without previous treatment and a minimal follow-up of 5 yrs were included. Average tumor thickness in the PRBT group (n=62) was 8.4 mm, base 13.1 mm, fovea tumor distance 3.9 mm, disc tumor distance 5.5 mm. In the plaque group (n=266) the average tumor thickness was 4.2 mm with a tumor base of 11.2 mm. The tumor disc distance was 8.2 mm, the fovea tumor distance was 7.8 mm.

Results: Both groups were equal regarding age and predisposing disease. In general larger and more posteriorly located tumors were treated by PRBT. There was no planned consecutive treatment in the plaque radiation group. 71% of the PBRT group received endoresection or transscleral resection of the tumor. Only 18 patients in the PBRT group did not require additional surgery and were considered as a separate group. Average survical rate was 93.7% in the plaque group and 96.1% in the PRBT group after 5 years (p>0.05). Similarly, there was no difference in the rate of enucleation (PBRT 1.7% vs. plaque 1.2%). Only the rate of metastasis was significantly higher in the PBRT group (PBRT 8.2% vs. Ru-106 5.9%). This difference was not present in the PBRT group without further surgery.

Discussion: This comparison of patients with consecutively treated tumors demonstrates the effectiveness of proton beam irradiation to control tumor growth and preservation of the globe. Proton beam is equivalent to plaque irradiation with respect to survical even in larger tumors. This study however demonstrates a higher rate of metastesis in larger tumors and the need for consecutive surgery to maintain the eye.