title: Outcomes of Proton Beam Radiotherapy for Large Non-Peripapillary Choroidal and Ciliary Body Melanoma at TRIUMF and the BC Cancer Agency.
abstract: OBJECTIVE
  To report outcomes and toxicity after proton beam radiotherapy for non-peripapillary choroidal and ciliary body melanoma considered unsuitable for other eye-sparing therapies.
  
  
  METHODS
  An existing database of 77 patients with non-peripapillary tumors treated at TRIUMF, Canada, including patient, tumor, and treatment characteristics, was updated with ocular complications and follow-up status from chart reviews.
  
  
  RESULTS
  Most of the patients had large tumors: 61% were T3/T4 tumors (AJCC classification), while 48% were large by the Collaborative Ocular Melanoma Study classification. The median thickness was 7.1 mm, and the ciliary body was involved in 35%. After 5 and 10 years, the actuarial ocular tumor control rate was 85 and 85%, metastasis-free survival was 72 and 57%, overall survival was 77 and 63%, the enucleation rate was 22 and 22%, and complete blindness was found in 38 and 38%, respectively. On univariate analysis, patients with ciliary body involvement had significantly worse metastasis-free survival and overall survival rates compared to patients without ciliary body involvement (p < 0.001).
  
  
  CONCLUSIONS
  Proton therapy for large anteriorly located tumors resulted in acceptable ocular tumor control and survival rates. The risk of blindness and severe toxicity requiring enucleation was low, and a substantial proportion of patients maintained useful vision.
authors.affiliation: Radiation Oncology, British Columbia Cancer Agency and University of British Columbia, Vancouver, B.C., Canada; Department of Oncology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Britta
authors.initials: B
authors.lastname: Weber
authors.affiliation: Department of Ophthalmology and Visual Sciences, Vancouver Hospital Eye Care Center and University of British Columbia, Vancouver, B.C., Canada.
authors.forename: Katherine
authors.initials: K
authors.lastname: Paton
authors.affiliation: Radiation Oncology, British Columbia Cancer Agency and University of British Columbia, Vancouver, B.C., Canada.
authors.forename: Roy
authors.initials: R
authors.lastname: Ma
authors.affiliation: Radiation Oncology, British Columbia Cancer Agency and University of British Columbia, Vancouver, B.C., Canada.
authors.forename: Tom
authors.initials: T
authors.lastname: Pickles
keywords: Ciliary body; Outcomes; Proton therapy; Toxicity; Uveal melanoma