Survival after proton-beam irradiation of uveal melanomas.
OBJECTIVE
To evaluate the independent prognostic factors for survival, metastasis, local recurrence, and enucleation in patients who had undergone proton-beam therapy for posterior uveal melanomas.


METHODS
Interventional case series.


METHODS
In this retrospective study, 224 consecutive incident cases were treated at the Biomedical Cyclotron Centre (Nice, France) from June 1991 to December 1997. Overall, metastasis-free, local recurrence-free, and enucleation-free survival rates were calculated according to the Kaplan-Meier method using the log-rank test. The multivariate prognostic analysis was performed using the Cox proportional hazards model.


RESULTS
The 5-year overall survival rate was 78.1% (SE: 3.7%). A largest basal tumor diameter (LTD) below 10 mm and female sex were independently associated with a better prognosis. The 5-year metastasis-free survival rate was 75.6% (SE: 3.6%). Only an LTD above 10 mm and ciliary body involvement were independently associated with metastasis. Ten patients (4.5%) had a local recurrence, which was correlated with the risk of metastasis (P =.045). The 5-year enucleation-free survival rate was 69.6% (SE: 4.0%). Once again, an LTD below 10 mm and female sex were predictive of a better prognosis.


CONCLUSIONS
Our results with proton-beam therapy correspond to those reported in the literature. This treatment strategy is safe and yields predictably good results. In addition to the two independent prognostic factors for survival and metastasis, namely LTD and ciliary body involvement, sex also had a significant impact in our case series, but the clinical relevance of this finding is unknown.
Kodjikian
L
L
Department of Ophtalmology, Croix-Rousse Hospital, and Laboratory of Biomaterials and Matrix Remodelling, Claude Bernard University, Lyon, France. kodjikian.laurent@wanadoo.fr
Roy
P
P
Rouberol
F
F
Garweg
J G
JG
Chauvel
P
P
Manon
L
L
Jean-Louis
B
B
Little
R E
RE
Sasco
A J
AJ
Grange
J D
JD
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D018572:Disease-Free Survival; D015353:Eye Enucleation; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000401:mortality* / Q000532:radiotherapy*; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000401:mortality; D016016:Proportional Hazards Models; D011882:Radiotherapy, High-Energy / Q000401:mortality*; D012189:Retrospective Studies; D012737:Sex Factors; D015996:Survival Rate; D014604:Uveal Neoplasms / Q000401:mortality* / Q000532:radiotherapy*