title: Long-term results of low-dose proton beam therapy for circumscribed choroidal hemangiomas.
abstract: OBJECTIVE
  To evaluate the long-term efficacy and outcome of low-dose proton beam irradiation in the treatment of symptomatic circumscribed choroidal hemangioma.
  
  
  METHODS
  Retrospective review of 71 patients with symptomatic circumscribed choroidal hemangiomas treated by proton beam irradiation between September 1994 and October 2002 using a total dose of 20 Cobalt Gray Equivalent.
  
  
  RESULTS
  The median follow-up was 52 months (8-133 months). Retinal reattachment was obtained in all cases. Tumor thickness decreased in all cases and a completely flat scar was obtained in 65 patients (91.5%). Visual acuity was improved by two lines or more in 37 of the 71 patients (52%), and in 30 of the 40 patients (75%) treated within 6 months after onset of the first symptoms. The main radiation complications detected during follow-up were cataract (28%) and radiation-induced maculopathy (8%). None of the 71 patients developed eyelid sequelae or neovascular glaucoma.
  
  
  CONCLUSIONS
  Proton beam irradiation with a total dose of 20 Cobalt Gray Equivalent appears to be a valid treatment for circumscribed choroidal hemangiomas, inducing definitive retinal reattachment and decreasing tumor thickness. However, delayed radiation-induced maculopathy may occur. A successful functional outcome is dependent on a short interval between onset of the first symptoms and initiation of therapy.
authors.affiliation: Department of Ocular Oncology, Institut Curie, Paris, France. christine.levy@curie.net
authors.forename: Christine
authors.initials: C
authors.lastname: Levy-Gabriel
authors.forename: Livia Lumbroso-Le
authors.initials: LL
authors.lastname: Rouic
authors.forename: Corinne
authors.initials: C
authors.lastname: Plancher
authors.forename: Remi
authors.initials: R
authors.lastname: Dendale
authors.forename: Sabine
authors.initials: S
authors.lastname: Delacroix
authors.forename: Bernard
authors.initials: B
authors.lastname: Asselain
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Habrand
authors.forename: Laurence
authors.initials: L
authors.lastname: Desjardins
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002386:Cataract / Q000209:etiology; D002830:Choroid Neoplasms / Q000503:physiopathology / Q000532:radiotherapy*; D003037:Cobalt Radioisotopes / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006391:Hemangioma / Q000503:physiopathology / Q000532:radiotherapy*; D006801:Humans; D007908:Lens, Crystalline / Q000528:radiation effects; D008266:Macula Lutea / Q000528:radiation effects; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011522:Protons; D011832:Radiation Injuries / Q000209:etiology; D011879:Radiotherapy Dosage; D012164:Retinal Diseases / Q000209:etiology; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology
chemical_list: D003037:Cobalt Radioisotopes; D011522:Protons