Fractionated stereotactic radiotherapy for uveal melanoma, late clinical results

Karin Muller; Nicole Naus; Peter J C M Nowak; Paul I M Schmitz; Connie de Pan; Cornelis A van Santen; Johannes P Marijnissen; Dion A Paridaens; Peter C Levendag; Gré P M Luyten

doi:10.1016/j.radonc.2011.06.038

Fractionated stereotactic radiotherapy for uveal melanoma, late clinical results

Karin Muller, Nicole Naus, Peter J C M Nowak, Paul I M Schmitz, Connie de Pan, Cornelis A van Santen, Johannes P Marijnissen, Dion A Paridaens, Peter C Levendag, Gré P M Luyten

Orbita and oculoplastic surgery

Research output: Contribution to journal › Article › Research › peer-review

Abstract

PURPOSE: To determine local control, late toxicity and metastatic free survival (MFS) of patients treated with fractionated stereotactic radiation therapy (fSRT) for uveal melanoma (UM).

METHODS AND MATERIALS: Between 1999 and 2007, 102 UM patients were included in a prospective study of a single institution (median follow-up (FU) 32 months; median tumor thickness 6 mm); five fractions of 10 Gy were given. Primary endpoints were local tumor control and late toxicity (including visual outcome and eye preservation). Secondary endpoint was MFS.

RESULTS: Local tumor control was achieved in 96% of the patients. Fifteen enucleations were performed, 2-85 months after radiation. Four eyes were enucleated because of local tumor progression. Nine patients developed grade 3 or 4 neovascular glaucoma (NVG), 19 developed severe retinopathy, 13 developed opticoneuropathy grade 3 or 4, 10 developed cataract grade 3, and 10 patients suffered from keratitis sicca. Best corrected visual acuity (BCVA) decreased from a mean of 0.26 at diagnosis to 0.16, 3 months after radiation and it gradually declined to 0.03, 4 years after therapy. The 5-year actuarial MFS was 75% (95% CIs: 62-84%).

CONCLUSIONS: fSRT is an effective treatment modality for uveal melanoma with a good local control. With that, fSRT is a serious eye sparing treatment modality. However, our FU is relatively short. Also, the number of secondary enucleations is substantial, mainly caused by NVG.

Original language	English
Pages (from-to)	219-24
Number of pages	6
Journal	Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
Volume	102
Issue number	2
DOIs	https://doi.org/10.1016/j.radonc.2011.06.038
Publication status	Published - Feb 2012

Keywords

Adult
Aged
Aged, 80 and over
Dose Fractionation, Radiation
Eye Enucleation
Female
Humans
Logistic Models
Male
Melanoma/pathology
Middle Aged
Neoplasm Staging
Prospective Studies
Radiotherapy Dosage
Stereotaxic Techniques
Survival Rate
Treatment Outcome
Uveal Neoplasms/pathology

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10.1016/j.radonc.2011.06.038

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Muller, K., Naus, N., Nowak, P. J. C. M., Schmitz, P. I. M., de Pan, C., van Santen, C. A., Marijnissen, J. P., Paridaens, D. A., Levendag, P. C., & Luyten, G. P. M. (2012). Fractionated stereotactic radiotherapy for uveal melanoma, late clinical results. Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 102(2), 219-24. https://doi.org/10.1016/j.radonc.2011.06.038

@article{2532a81afd164c79a87eeef27de86ffc,

title = "Fractionated stereotactic radiotherapy for uveal melanoma, late clinical results",

abstract = "PURPOSE: To determine local control, late toxicity and metastatic free survival (MFS) of patients treated with fractionated stereotactic radiation therapy (fSRT) for uveal melanoma (UM).METHODS AND MATERIALS: Between 1999 and 2007, 102 UM patients were included in a prospective study of a single institution (median follow-up (FU) 32 months; median tumor thickness 6 mm); five fractions of 10 Gy were given. Primary endpoints were local tumor control and late toxicity (including visual outcome and eye preservation). Secondary endpoint was MFS.RESULTS: Local tumor control was achieved in 96% of the patients. Fifteen enucleations were performed, 2-85 months after radiation. Four eyes were enucleated because of local tumor progression. Nine patients developed grade 3 or 4 neovascular glaucoma (NVG), 19 developed severe retinopathy, 13 developed opticoneuropathy grade 3 or 4, 10 developed cataract grade 3, and 10 patients suffered from keratitis sicca. Best corrected visual acuity (BCVA) decreased from a mean of 0.26 at diagnosis to 0.16, 3 months after radiation and it gradually declined to 0.03, 4 years after therapy. The 5-year actuarial MFS was 75% (95% CIs: 62-84%).CONCLUSIONS: fSRT is an effective treatment modality for uveal melanoma with a good local control. With that, fSRT is a serious eye sparing treatment modality. However, our FU is relatively short. Also, the number of secondary enucleations is substantial, mainly caused by NVG.",

keywords = "Adult, Aged, Aged, 80 and over, Dose Fractionation, Radiation, Eye Enucleation, Female, Humans, Logistic Models, Male, Melanoma/pathology, Middle Aged, Neoplasm Staging, Prospective Studies, Radiotherapy Dosage, Stereotaxic Techniques, Survival Rate, Treatment Outcome, Uveal Neoplasms/pathology",

author = "Karin Muller and Nicole Naus and Nowak, {Peter J C M} and Schmitz, {Paul I M} and {de Pan}, Connie and {van Santen}, {Cornelis A} and Marijnissen, {Johannes P} and Paridaens, {Dion A} and Levendag, {Peter C} and Luyten, {Gr{\'e} P M}",

year = "2012",

month = feb,

doi = "10.1016/j.radonc.2011.06.038",

language = "English",

volume = "102",

pages = "219--24",

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Muller, K, Naus, N, Nowak, PJCM, Schmitz, PIM, de Pan, C, van Santen, CA, Marijnissen, JP, Paridaens, DA, Levendag, PC & Luyten, GPM 2012, 'Fractionated stereotactic radiotherapy for uveal melanoma, late clinical results', Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, vol. 102, no. 2, pp. 219-24. https://doi.org/10.1016/j.radonc.2011.06.038

TY - JOUR

T1 - Fractionated stereotactic radiotherapy for uveal melanoma, late clinical results

AU - Muller, Karin

AU - Naus, Nicole

AU - Nowak, Peter J C M

AU - Schmitz, Paul I M

AU - de Pan, Connie

AU - van Santen, Cornelis A

AU - Marijnissen, Johannes P

AU - Paridaens, Dion A

AU - Levendag, Peter C

AU - Luyten, Gré P M

PY - 2012/2

Y1 - 2012/2

N2 - PURPOSE: To determine local control, late toxicity and metastatic free survival (MFS) of patients treated with fractionated stereotactic radiation therapy (fSRT) for uveal melanoma (UM).METHODS AND MATERIALS: Between 1999 and 2007, 102 UM patients were included in a prospective study of a single institution (median follow-up (FU) 32 months; median tumor thickness 6 mm); five fractions of 10 Gy were given. Primary endpoints were local tumor control and late toxicity (including visual outcome and eye preservation). Secondary endpoint was MFS.RESULTS: Local tumor control was achieved in 96% of the patients. Fifteen enucleations were performed, 2-85 months after radiation. Four eyes were enucleated because of local tumor progression. Nine patients developed grade 3 or 4 neovascular glaucoma (NVG), 19 developed severe retinopathy, 13 developed opticoneuropathy grade 3 or 4, 10 developed cataract grade 3, and 10 patients suffered from keratitis sicca. Best corrected visual acuity (BCVA) decreased from a mean of 0.26 at diagnosis to 0.16, 3 months after radiation and it gradually declined to 0.03, 4 years after therapy. The 5-year actuarial MFS was 75% (95% CIs: 62-84%).CONCLUSIONS: fSRT is an effective treatment modality for uveal melanoma with a good local control. With that, fSRT is a serious eye sparing treatment modality. However, our FU is relatively short. Also, the number of secondary enucleations is substantial, mainly caused by NVG.

AB - PURPOSE: To determine local control, late toxicity and metastatic free survival (MFS) of patients treated with fractionated stereotactic radiation therapy (fSRT) for uveal melanoma (UM).METHODS AND MATERIALS: Between 1999 and 2007, 102 UM patients were included in a prospective study of a single institution (median follow-up (FU) 32 months; median tumor thickness 6 mm); five fractions of 10 Gy were given. Primary endpoints were local tumor control and late toxicity (including visual outcome and eye preservation). Secondary endpoint was MFS.RESULTS: Local tumor control was achieved in 96% of the patients. Fifteen enucleations were performed, 2-85 months after radiation. Four eyes were enucleated because of local tumor progression. Nine patients developed grade 3 or 4 neovascular glaucoma (NVG), 19 developed severe retinopathy, 13 developed opticoneuropathy grade 3 or 4, 10 developed cataract grade 3, and 10 patients suffered from keratitis sicca. Best corrected visual acuity (BCVA) decreased from a mean of 0.26 at diagnosis to 0.16, 3 months after radiation and it gradually declined to 0.03, 4 years after therapy. The 5-year actuarial MFS was 75% (95% CIs: 62-84%).CONCLUSIONS: fSRT is an effective treatment modality for uveal melanoma with a good local control. With that, fSRT is a serious eye sparing treatment modality. However, our FU is relatively short. Also, the number of secondary enucleations is substantial, mainly caused by NVG.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Dose Fractionation, Radiation

KW - Eye Enucleation

KW - Female

KW - Humans

KW - Logistic Models

KW - Male

KW - Melanoma/pathology

KW - Middle Aged

KW - Neoplasm Staging

KW - Prospective Studies

KW - Radiotherapy Dosage

KW - Stereotaxic Techniques

KW - Survival Rate

KW - Treatment Outcome

KW - Uveal Neoplasms/pathology

U2 - 10.1016/j.radonc.2011.06.038

DO - 10.1016/j.radonc.2011.06.038

M3 - Article

C2 - 21864922

SN - 0167-8140

VL - 102

SP - 219

EP - 224

JO - Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology

JF - Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology

IS - 2

ER -

Fractionated stereotactic radiotherapy for uveal melanoma, late clinical results

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Keywords

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