Proton beam radiotherapy of choroidal melanoma: the Liverpool-Clatterbridge experience.
OBJECTIVE
To report on outcomes after proton beam radiotherapy of choroidal melanoma using a 62-MeV cyclotron in patients considered unsuitable for other forms of conservative therapy.


METHODS
A total of 349 patients with choroidal melanoma referred to the Liverpool Ocular Oncology Centre underwent proton beam radiotherapy at Clatterbridge Centre for Oncology (CCO) between January 1993 and December 2003. Four daily fractions of proton beam radiotherapy were delivered, with a total dose of 53.1 proton Gy, and with lateral and distal safety margins of 2.5 mm. Outcomes measured were local tumor recurrence; ocular conservation; vision; and metastatic death according to age, gender, eye, visual acuity, location of anterior and posterior tumor margins, quadrant, longest basal tumor dimension, tumor height, extraocular extension, and retinal invasion.


RESULTS
The 5-year actuarial rates were 3.5% for local tumor recurrence, 9.4% for enucleation, 79.1% for conservation of vision of counting fingers or better, 61.1% for conservation of vision of 20/200 or better, 44.8% for conservation of vision of 20/40 or better, and 10.0% for death from metastasis.


CONCLUSIONS
Proton beam radiotherapy with a 62 MeV cyclotron achieves high rates of local tumor control and ocular conservation, with visual outcome depending on tumor size and location.
Damato
Bertil
B
Ocular Oncology Service, St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom. Bertil@damato.co.uk
Kacperek
Andrzej
A
Chopra
Mona
M
Campbell
Ian R
IR
Errington
R Douglas
RD
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002830:Choroid Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D017357:Cyclotrons; D015353:Eye Enucleation; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D011446:Prospective Studies; D016019:Survival Analysis; D017211:Treatment Failure; D014792:Visual Acuity