[Eye-preserving treatment of uveal melanoma. Leidse Oogmelanoom Groep].
Over 100 new cases of uveal melanoma are diagnosed annually in the Netherlands. In the absence of metastases, eye-preserving treatment is possible in principle. Since 1984, Dutch patients are referred for eye-preserving treatment to Leiden University Hospital which consequently has gained great experience. Brachytherapy (with Ruthenium-106 applicators) is only suitable for uveal melanomas with a diameter < or = 15 mm and a prominence (thickness perpendicular to the sclera) < or = 5 mm; after 10 years, the eye was preserved in 80% of the patients; 75% retained a visual acuity > or = 0.25. Proton irradiation is being applied for large, strongly prominent melanomas in patients for whom enucleation is not acceptable, for instance with a melanoma in the only eye still functioning. The eyes could be preserved in 83.3% over a period of 5 years. Transpupillary thermotherapy combined with episcleral Ruthenium-106 application is called sandwich therapy; in a study involving 50 patients, 49 melanomas (98%) began to regress within 4 weeks and after a follow-up period of 12 months all tumours with a prominence < 5 mm had regressed completely.
Keunen
J E
JE
Academisch Ziekenhuis, afd. Oogheelkunde, Leiden.
Bleeker
J C
JC
D001918:Brachytherapy; D015353:Eye Enucleation; D006801:Humans; D006979:Hyperthermia, Induced; D007167:Immunotherapy; D008545:Melanoma / Q000473:pathology / Q000628:therapy*; D009361:Neoplasm Invasiveness; D061766:Proton Therapy; D012429:Ruthenium Radioisotopes / Q000627:therapeutic use; D014604:Uveal Neoplasms / Q000473:pathology / Q000628:therapy*
D012429:Ruthenium Radioisotopes