title: Proton beam radiotherapy of iris melanoma.
abstract: OBJECTIVE
  To report on outcomes after proton beam radiotherapy of iris melanoma.
  
  
  METHODS
  Between 1993 and 2004, 88 patients with iris melanoma received proton beam radiotherapy, with 53.1 Gy in 4 fractions.
  
  
  RESULTS
  The patients had a mean age of 52 years and a median follow-up of 2.7 years. The tumors had a median diameter of 4.3 mm, involving more than 2 clock hours of iris in 32% of patients and more than 2 hours of angle in 27%. The ciliary body was involved in 20%. Cataract was present in 13 patients before treatment and subsequently developed in another 18. Cataract had a 4-year rate of 63% and by Cox analysis was related to age (p = 0.05), initial visual loss (p < 0.0001), iris involvement (p < 0.0001), and tumor thickness (p < 0.0001). Glaucoma was present before treatment in 13 patients and developed after treatment in another 3. Three eyes were enucleated, all because of recurrence, which had an actuarial 4-year rate of 3.3% (95% CI 0-8.0%).
  
  
  CONCLUSIONS
  Proton beam radiotherapy of iris melanoma is well tolerated, the main problems being radiation-cataract, which was treatable, and preexisting glaucoma, which in several patients was difficult to control.
authors.affiliation: St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK. Bertil@damato.co.uk
authors.forename: Bertil
authors.initials: B
authors.lastname: Damato
authors.forename: Andrzej
authors.initials: A
authors.lastname: Kacperek
authors.forename: Mona
authors.initials: M
authors.lastname: Chopra
authors.forename: Martin A
authors.initials: MA
authors.lastname: Sheen
authors.forename: Ian R
authors.initials: IR
authors.lastname: Campbell
authors.forename: R Douglas
authors.initials: RD
authors.lastname: Errington
mesh_terms: D000328:Adult; D000368:Aged; D002386:Cataract / Q000150:complications / Q000628:therapy; D015353:Eye Enucleation; D005260:Female; D005901:Glaucoma / Q000150:complications / Q000628:therapy; D006801:Humans; D015811:Iris Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008545:Melanoma / Q000473:pathology / Q000532:radiotherapy*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D016016:Proportional Hazards Models; D011446:Prospective Studies; D061766:Proton Therapy; D016896:Treatment Outcome; D014792:Visual Acuity / Q000528:radiation effects; D011522:Protons
chemical_list: D011522:Protons