title: Preliminary results of proton radiotherapy for choroidal melanoma - the Kraków experience.
abstract: OBJECTIVE
  The objective of the study was to present the preliminary results of proton radiotherapy as a method for treating 15 patients with choroidal melanoma.
  
  
  METHODS
  The proton radiotherapy was administered using beams providing energy levels of 60 MeV, which ensures a clinical range of 28.4 mm. In addition, the beam has a very narrow penumbra of 1.3 mm and a sharp distal dose fall-off. All patients received the dose of 60 CGE (cobalt gray equivalent) given to the PTV (planning target volume). This dose was administered in 4 fractions over 4 successive days of treatment.
  
  
  RESULTS
  The tumour had regressed in 8 patients (53.3%) and remained stable in 3 patients (20%). The large tumours in another 3 patients (20%) were removed during vitrectomy (endoresection), which increased the number of patients with tumour regression up to 11 (73.3%). In the case of 1 patient, despite intraocular tumour regression occurring the choroidal melanoma had spread multifocally into the orbit, which necessitated orbit exenteration. The results ensured that the eyeballs of 14 patients (93.3%) could be saved. The follow-up period for the 15 patients ranged between 8 and 26 months (average: 17.4 months, median: 19 months). In this period some side effects were noted: an increase in intraocular pressure, retinal detachment, cataract, maculopathy, neuropathy and vitreous haemorrhaging.
  
  
  CONCLUSIONS
  The preliminary results confirm that proton radiotherapy is an effective method for treating patients with choroidal melanoma. This method ensures an eyeball preservation rate of 93%, with the vision function of 80% of the patients being saved.
authors.affiliation: Department of Oncology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Krakow Branch, Poland ; Department of Ophthalmology and Ocular Oncology Clinic, Jagiellonian University, Collegium Medicum , Krakow, Poland.
authors.forename: Beata
authors.initials: B
authors.lastname: Sas-Korczyńska
authors.affiliation: Department of Ophthalmology and Ocular Oncology Clinic, Jagiellonian University, Collegium Medicum , Krakow, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Markiewicz
authors.affiliation: Department of Ophthalmology and Ocular Oncology Clinic, Jagiellonian University, Collegium Medicum , Krakow, Poland.
authors.forename: Bożena
authors.initials: B
authors.lastname: Romanowska-Dixon
authors.affiliation: Department of Ophthalmology and Ocular Oncology Clinic, Jagiellonian University, Collegium Medicum , Krakow, Poland ; Department of Radiotherapy, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Krakow Branch, Poland.
authors.forename: Elżbieta
authors.initials: E
authors.lastname: Pluta
keywords: choroidal melanoma; ocular melanoma; proton radiotherapy