Long-term results of helium ion radiotherapy for uveal melanoma

Radiation

190

Oncology,

Biology,

Physics

October

1989,

Volume

17, Supplement

1

143 Long-Term

Results

of

Helium

Ion

Radiotherapy

for

Uveal

Melanoma

David Linstadt MD, Joseph Ft. Castro MD, Mary Decker MD, Jeanne M. Quivey MD, Devron H. Char MD, and Theodore L. Phillips MD Departments

of Radiation Oncology and Ophthalmology,

Radiotherapy

Section, Division of Biology and Medicine, Lawrence Berkeley Laboratory, Berkeley, CA

Between

1978

at Lawrence months). specific The

had vision analysis These

actuarial

rate, 81%; effect

follow-up

improve

identified

several

melanoma

results which

likelihood

results

risk of developing

post-treatment

either

uveal

on vision

vision

melanoma

of follow-up

treatment

59 months).

long-term

with

Length

of treatment

(median

long-term

substantial

patients

The 5-year

maintained with

307

Laboratory.

long-term

patients

1988,

Berkeley

of 36 months

uveal

and

survival

better

University of California, San Francisco, San Francisco, CA

are as follows:

with

pre-treatment

independent

risk factors

which

confirm

that

helium

ion irradiation

combines

high

rates of local control,

visual

initial

visual

appeared

survival,

acuity

to influence form

follow-up

of 20/200

in vision

chart.

acuity.

is an effective

rate, 17%.

a minimum

change

vision

42

(median

rate, 3.2%; disease-

with

The median

of their

ion irradiation

36%; and enucleation

in 164 patients

or better.

2 lines

helium

local failure

glaucoma,

was analyzed

41% of patients

within

with

ranged from 1 to 115 months

neovascular

of 20/200

treated

was a loss of 5 lines on the standard

or remain

of vision

were

or

for all

However,

37%

A multivariate treatment

outcome.

of treatment

and eye retention

for

with a

preservation.

144 CILIARY BODY MELANOMAS TREATED WITH HELIUM PARTICLE IRRADIATION Mary M. Decker, M.9.‘) Joseph R. Castro, M.9.’ ‘3 David E. Linstadt, y$I.‘, Paula L. Petti, Ph.D. , Jeanne M. Quivey, M.D. , Devron H. Char, M.D. ’ 1

Department of Radiatgn Oncology and ‘Department of Ophthalmology, University of California, San Francisco, 94143, Lawrence Berkeley Laboratory, University of California, Berkeley, 94720 Melanoma involving the ciliary body is a rare tumor which carries a poor prognosis when compared to all uveal melanomas. We have treated 54 ciliary body melanomas with helium ions from 1978 to 1985. The five year disease specific survival rate at five years is 59% despite a five year local control rate of 98%. The incidence of neovascular glaucoma (NVG) at five years is 43%. The five year actuarial rate of enucleation is 26%. Enucleation was done for pain and/or NVG. Univariate analysis showed treatment volume and initial ultrasound height to be statistically significant predictors for the development of NVG (p = .0017, p = .Ol 1 respectively) and enucleation (p = .0078, p = .076 respectively). The greatest diameter of the tumor was predictive of loss of vision, enucleation, and death from metastases (p = .05, p= .04, p = .04 respectively). Multivariate analysis showed that the greatest diameter of the tumor was the most importagt predictor of death from metastases. Seventy percent of cases of NVG occurred in patients with tumor volume 2 5.5 cm . Seventy-four percent of the cases of NVG occurred in patients with an initial ultrasound height > 9.2mm. Using this information patients at high risk for NVG could be considered for prophylactic treatment with panretin2 photocoagulation to prevent NVG.

Supported in part by grants from That Man May See, NIH E107504, NCI CA19136 and DOE contract DE-AC03-76SF00098.