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Proton beam therapy for presumed and confirmed iris melanomas: a review of 36 cases

  • Oncology
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Background

To report the clinical features and outcomes of iris melanomas treated by proton beam therapy.

Materials and methods

A retrospective study was conducted at the Croix-Rousse University Hospital of Lyon, Department of Ophthalmology, in 36 patients treated by proton beam therapy for presumed (n = 29) and confirmed (n = 7) iris melanomas between July 1997 and October 2010. Ciliary body melanomas with iris involvement were excluded. The patients’ mean age was 54.4 years (range, 22–82 years). The average tumor diameter was 3.8 mm (range, 2.5–8.0). The iridocorneal angle was invaded by the tumor in 47 % of cases (n = 17), the ciliary body in 17 % of cases (n = 6), and the sclera in 3 % (n = 1). Raised intraocular pressure was present before treatment in 11.1 % of cases (n = 4). Tumor biopsy was performed in 19 % of cases (n = 7). Four patients had undergone an initial incomplete surgical excision of tumor before radiotherapy. Surgical preparation of the eye with tantalum ring positioning had been performed in all cases 3–4 weeks before irradiation. The prescribed dose was 60 Cobalt Gray Equivalent (CGE) of proton beam radiotherapy delivered in four fractions on four consecutive days.

Results

The median follow-up was 50 months (mean 60.5, range 15–136). One patient (2.7 %) was lost to follow-up. None of the patients showed tumor progression, local recurrence, or metastasis. None of the patients required secondary enucleation. Cataract was developed in 62 % of patients, glaucoma in two cases (6 %) after irradiation, and hyphema with the aggravation of pre-existing glaucoma in one patient. No patients developed neovascular glaucoma.

Conclusions

Proton beam therapy appears to be the treatment of choice for the conservative treatment of iris melanomas with excellent tumor control and an acceptable rate of complications. Longer follow-up studies on a larger series is necessary to consolidate these results.

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Disclosure information

The above authors confirm that this manuscript is not related to any proprietary or commercial interests. No sponsoring organizations have been involved, and no grants were received from any organization or institution.

Ethics approval

This study was conducted with the approval of the Ethical Review Board of the University of Lyon.

Meeting presentation

A limited account of this study was presented at the 36th Spring Meeting of the “Ophthalmic Oncology Group” (18th–20th March 2010, Liverpool, UK).

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Croix-Rousse University Hospital, University Claude Bernard Lyon 1, 103 Grande Rue de la Croix-Rousse, 69317, Lyon Cedex 04, France

    Ahmed Rahmi, Laurent Kodjikian, Philippe Denis & Jean Daniel Grange

  2. Department of Radiotherapy-Oncology, Biomedical Cyclotron of the Antoine Lacassagne Comprehensive Cancer Centre (Nice), University Sophia-Antipolis, 227 Avenue de la Lanterne, 06200, Nice Cedex 2, France

    Hamid Mammar, Juliette Thariat, Gaelle Angellier, Joel Herault & Pierre Chauvel

Authors
  1. Ahmed Rahmi
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  2. Hamid Mammar
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  3. Juliette Thariat
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  4. Gaelle Angellier
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  5. Joel Herault
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  6. Pierre Chauvel
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  7. Laurent Kodjikian
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  8. Philippe Denis
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  9. Jean Daniel Grange
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Corresponding author

Correspondence to Jean Daniel Grange.

Additional information

Study performed at Hospices Civils de Lyon, Quai des Célestins, 69288 Lyon Cedex 02, France

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Rahmi, A., Mammar, H., Thariat, J. et al. Proton beam therapy for presumed and confirmed iris melanomas: a review of 36 cases. Graefes Arch Clin Exp Ophthalmol 252, 1515–1521 (2014). https://doi.org/10.1007/s00417-014-2735-y

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  • DOI: https://doi.org/10.1007/s00417-014-2735-y

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