title: [Double irradiation for macroscopic radioresistance or recurrence of melanomas of the posterior uvea: clinical, ballistic, therapeutic and prognostic aspects. Series of 19 cases among 462 patients].
abstract: We describe two comparative series of patients treated with double-dose betaraysbrachytherapy (106 Ruthenium) between 1983 and 1994, and double-dose proton beam therapy between 1991 and 1996. The indications for double-dose irradiation with the same radio-element corresponded to "macroscopically abnormal" situations: immediate and prolonged radioresistance, recurrence or secondary radioresistance. Thirteen cases are called series 1 (Ruthenium) and 6 cases are called series 2 (protons). The series 1 allows a more reliable study as far as follow-up is higher (5.8 to 7.5 years) than in series 2 where the follow-up is shorter (13.6 to 29 months). Although double-dose irradiation was macroscopically efficient in 11 out of 13 cases in series 1, and in 3 out of 6 cases in series 2 (stabilization or decrease of tumour height measured before the second therapeutic session), 2 patients are deceased and 1 has a metastatic disease in the group "recurrence" of Ruthenium serie. Another one has also a metastatic disease in the group "recurrence" of protons series. Nevertheless double-dose radiotherapy allows a complementary decrease or stabilization of tumour height after a first session. It also decreases the indications for enucleation if there is no severe anatomic complications, when a tumour does not regress or recurs after a first session of radiations.
authors.affiliation: Clinique Ophtalmologique Universitaire, Hôpital de la Croix-Rousse, 93, grande rue, 69004 Lyon.
authors.forename: J D
authors.initials: JD
authors.lastname: Grange
authors.forename: N
authors.initials: N
authors.lastname: Duquesne
authors.forename: F
authors.initials: F
authors.lastname: Roubeyrol
authors.forename: D
authors.initials: D
authors.lastname: Branisteanu
authors.forename: K
authors.initials: K
authors.lastname: Sandon
authors.forename: J
authors.initials: J
authors.lastname: Fleury
authors.forename: J P
authors.initials: JP
authors.lastname: Gerard
authors.forename: P
authors.initials: P
authors.lastname: Chauvel
authors.forename: G
authors.initials: G
authors.lastname: Pinzaru
authors.forename: B
authors.initials: B
authors.lastname: Jean-Louis
authors.forename: B
authors.initials: B
authors.lastname: Bievelez
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000473:pathology / Q000532:radiotherapy*; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000532:radiotherapy*; D011379:Prognosis; D011836:Radiation Tolerance; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013997:Time Factors; D014604:Uveal Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000532:radiotherapy*