Proton beam radiotherapy for uveal melanoma: results of Curie Institut-Orsay proton therapy center (ICPO).
OBJECTIVE
This study reports the results of proton beam radiotherapy based on a retrospective series of patients treated for uveal melanoma at the Orsay Center.


METHODS
Between September 1991 and September 2001, 1,406 patients with uveal melanoma were treated by proton beam radiotherapy. A total dose of 60 cobalt Gray equivalent (CGE) was delivered in 4 fractions on 4 days. Survival rates were determined using Kaplan-Meier estimates. Prognostic factors were determined by multivariate analysis using the Cox model.


RESULTS
The median follow-up was 73 months (range, 24-142 months). The 5-year overall survival and metastasis-free survival rates were 79% and 80.6%, respectively. The 5-year local control rate was 96%. The 5-year enucleation for complications rate was 7.7%. Independent prognostic factors for overall survival were age (p < 0.0001), gender (p < 0.0003), tumor site (p < 0.0001), tumor thickness (p = 0.02), tumor diameter (p < 0.0001), and retinal area receiving at least 30 CGE (p = 0.003). Independent prognostic factors for metastasis-free survival were age (p = 0.0042), retinal detachment (p = 0.01), tumor site (p < 0.0001), tumor volume (p < 0.0001), local recurrence (p < 0.0001), and retinal area receiving at least 30 CGE (p = 0.002). Independent prognostic factors for local control were tumor diameter (p = 0.003) and macular area receiving at least 30 CGE (p = 0.01). Independent prognostic factors for enucleation for complications were tumor thickness (p < 0.0001) and lens volume receiving at least 30 CGE (p = 0.0002).


CONCLUSIONS
This retrospective study confirms that proton beam radiotherapy ensures an excellent local control rate. Further clinical studies are required to decrease the incidence of postirradiation ocular complications.
Dendale
Rémi
R
Department of Radiation Oncology, Curie Institut, Paris, France. remi.dendale@curie.net
Lumbroso-Le Rouic
Livia
L
Noel
Georges
G
Feuvret
Loïc
L
Levy
Christine
C
Delacroix
Sabine
S
Meyer
Anne
A
Nauraye
Catherine
C
Mazal
Alejandro
A
Mammar
Hamid
H
Garcia
Paul
P
D'Hermies
François
F
Frau
Eric
E
Plancher
Corine
C
Asselain
Bernard
B
Schlienger
Pierre
P
Mazeron
Jean Jacques
JJ
Desjardins
Laurence
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D015353:Eye Enucleation / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008545:Melanoma / Q000401:mortality / Q000532:radiotherapy*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy / Q000601:surgery; D061766:Proton Therapy; D012189:Retrospective Studies; D015996:Survival Rate; D014604:Uveal Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D011522:Protons
D011522:Protons