Proton radiotherapy in advanced malignant melanoma of the conjunctiva.

Proton radiotherapy in advanced malignant melanoma of the conjunctiva.

Publication date: Mar 27, 2019

The management of conjunctival melanoma is challenging and frequently ends in exenteration. The aim of this retrospective study was to evaluate the long-term results of proton beam radiation with regard to various clinical parameters.

Eighty-nine patients with extended conjunctival melanoma (≥T2) and multifocal bulbar located tumors (T1c/d) were treated consecutively with proton radiotherapy (dose 45 Gy). The following parameters were assessed: TNM stage, tumor origin, local recurrence, performance of exenteration, occurrence of metastases, overall survival, and potential complications. A time-to-event analysis was preformed to the primary endpoints: relapse, metastasis, exenteration, and death by use of Kaplan-Meier cumulative survival estimates and Cox proportional hazards regression that provides hazard ratios and 95% confidence intervals.

The median follow-up time was 4.2 years (max. 21.7 years). Local recurrence and metastatic disease occurred in 33% and 16% of patients, respectively. Exenteration-free survival and overall survival tended to be worse in T3 melanoma. No association between tumor origin and local recurrence, metastatic disease, or overall survival was observed. Main complications after proton radiotherapy were sicca-syndrome (30%), secondary glaucoma (11%), and limbal stem cell deficiency (8%).

In summary, proton radiotherapy in conjunctival melanoma is an effective alternative to exenteration, with a 5-year cumulative probability of eye preservation of 69%.

Scholz, S.L., H’erault, J., Stang, A., Griewank, K.G., Meller, D., Thariat, J., Steuhl, K.P., Westekemper, H., and Sauerwein, W. Proton radiotherapy in advanced malignant melanoma of the conjunctiva. 22099. 2019 Graefes Arch Clin Exp Ophthalmol.

Concepts Keywords
Beam Radiation
Bulbar Eye neoplasm
Confidence Intervals Metastasis
Conjunctiva Conjunctiva
Conjunctival Radiation therapy
Cumulative Probability Cancer
Glaucoma RTT
Malignant Melanoma Melanoma
Melanoma Branches of biology
Metastases Health
Metastasis Medicine
Metastatic Radiotherapy
Proton Radiation
Radiation TNM stage tumor
Radiotherapy Limbal stem deficiency
Relapse Secondary glaucoma
Syndrome
TNM Stage
Tumor

Semantics

Type Source Name
disease DOID glaucoma
disease MESH glaucoma
disease DOID syndrome
disease MESH syndrome
pathway BSID Melanoma
gene UNIPROT MAX
gene UNIPROT COX5A
gene UNIPROT COX8A
gene UNIPROT CPOX
disease MESH death
disease MESH complications
disease MESH metastases
disease MESH recurrence
gene UNIPROT TENM1
disease MESH tumors
drug DRUGBANK Tricyclazole
gene UNIPROT DNMT1
gene UNIPROT CD69
gene UNIPROT CD5L
disease DOID conjunctival melanoma
disease DOID malignant melanoma
disease MESH malignant melanoma

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