[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].
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.
Grange
J D
JD
Clinique Ophtalmologique Universitaire, Hôpital de la Croix-Rousse, 93, grande rue, 69004 Lyon.
Duquesne
N
N
Roubeyrol
F
F
Branisteanu
D
D
Sandon
K
K
Fleury
J
J
Gerard
J P
JP
Chauvel
P
P
Pinzaru
G
G
Jean-Louis
B
B
Bievelez
B
B
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*