[What to think of "adjuvant" or "neoadjuvant" thermotherapy in the treatment of uveal melanomas?].
Before 810Nm laser thermotherapy has been usd for uveal melanoma, several authors especially in Essen (Germany) were asking themselves about the possibilities of xenon arc or argon laser effects on uveal melanomas. High rates of recurrences due to the non penetration of therapeutic light till the sclera had led to the conception of using adjuvant thermotherapy associated with radiotherapy, through microwaves, ultrasounds or ferromagnetic seeds. In Leyden (Netherlands) was proposed the use of 810Nm laser diode initially as an adjuvant to radiotherapy and later on as primary isolated treatment ("neo adjuvant" TTT), especially for small tumours located in the posterior pole (juxta-papillary tumours). TTT used alone should not be proposed for tumours of inital height of more than 3,5 to 4mm. "Neo adjuvant" thermotherapy finds some other indications like decompensated naevi responsible for macular detachment. Bigger peripheral tumours stabilized by protonbeam therapy but associated with persistent detachment after the 12(th) month could be treated with "adjuvant" TTT. Finally the importance of the quality of the tumour edges treatment should be emphasized.
Grange
J D
JD
Clinique Ophtalmologique Universitaire - Hôpital de la Croix-Rousse, 103, Grande-Rue, 69004 Lyon.
D000818:Animals; D002830:Choroid Neoplasms / Q000532:radiotherapy / Q000628:therapy; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D006224:Cricetinae; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D053685:Laser Therapy; D008028:Light Coagulation; D008297:Male; D008545:Melanoma / Q000532:radiotherapy* / Q000628:therapy*; D008647:Mesocricetus; D020360:Neoadjuvant Therapy; D011817:Rabbits; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D014604:Uveal Neoplasms / Q000532:radiotherapy* / Q000628:therapy*