title: [Results of proton beam irradiation for treatment of choroidal melanoma].
abstract: OBJECTIVE
  To evaluate the results of proton beam irradiation of choroidal melanomas on a large series of patients.
  
  
  METHODS
  Retrospective analysis of a series of patients treated with proton beam irradiation between 1991 and December 1998. The data were analyzed to evaluate the local tumor control as well as the general progression and metastatic rate of the patients. Statistical analysis served to isolate risk factors for relapse or metastasis.
  
  
  RESULTS
  We treated 1062 patients during the study period, with a median follow-up of 38 months. Local control was obtained for 97.1% of the patients. Tumors anterior to the equator were at risk for relapse. The survival rate was 92% at 2 years and 78% at 5 years. 73.1% of the 1062 patients died from metastasis, 6.1% of living patients presented with metastatic disease. The risk factors for death were the initial diameter, the age of the patient, and large tumor volume at diagnosis. Metastasis were essentially hepatic (94.6%). Risk factors for metastasis were: a large tumor volume, a lesion anterior or straddling the equator and the age of the patient. Ocular complications may induce a visual loss of 0.1 and less in 47% of the patients, due to optic nerve head and macular ischemia. 6% of the patients required secondary enucleation due to local complications (neovascular glaucoma).
  
  
  CONCLUSIONS
  Proton beam irradiation of choroidal melanoma allows good tumor control and eye retention. The survival prognosis is associated with the initial volume of the tumor. The functional results may be improved and new therapeutics are needed to treat metastatic disease.
authors.affiliation: Service d'Ophtalmologie, Institut Curie, 26 rue d'Ulm, 75231, Paris Cedex 05.
authors.forename: L
authors.initials: L
authors.lastname: Lumbroso
authors.forename: C
authors.initials: C
authors.lastname: Levy
authors.forename: C
authors.initials: C
authors.lastname: Plancher
authors.forename: E
authors.initials: E
authors.lastname: Frau
authors.forename: F
authors.initials: F
authors.lastname: D'hermies
authors.forename: P
authors.initials: P
authors.lastname: Schlienger
authors.forename: R
authors.initials: R
authors.lastname: Dendale
authors.forename: H
authors.initials: H
authors.lastname: Mammar
authors.forename: S
authors.initials: S
authors.lastname: Delacroix
authors.forename: C
authors.initials: C
authors.lastname: Nauraye
authors.forename: G
authors.initials: G
authors.lastname: Noel
authors.forename: R
authors.initials: R
authors.lastname: Ferrand
authors.forename: C
authors.initials: C
authors.lastname: Desblancs
authors.forename: A
authors.initials: A
authors.lastname: Mazal
authors.forename: P
authors.initials: P
authors.lastname: Validire
authors.forename: B
authors.initials: B
authors.lastname: Asselain
authors.forename: L
authors.initials: L
authors.lastname: Desjardins
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002830:Choroid Neoplasms / Q000175:diagnosis / Q000532:radiotherapy* / Q000601:surgery; D015353:Eye Enucleation; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000532:radiotherapy* / Q000601:surgery; D008875:Middle Aged; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D011379:Prognosis; D061766:Proton Therapy; D011859:Radiography; D011879:Radiotherapy Dosage; D012160:Retina / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D011522:Protons
chemical_list: D011522:Protons
vernacular_title: Résultats du traitement du mélanome de la choroïde par faisceau de protons.