Long-Term Outcomes of Ocular and Visual Preservation After Carbon Ion Radiation Therapy for Choroidal Malignant Melanoma.

IF 6.4 1区医学 Q1 ONCOLOGY

International Journal of Radiation Oncology Biology Physics Pub Date : 2024-10-16 DOI:10.1016/j.ijrobp.2024.10.008

Shuri Aoki, Masaru Wakatsuki, Hiroshi Tsuji, Hirokazu Makishima, Hiroaki Ikawa, Shigeru Yamada, Yuji Inoue, Hiroshi Goto, Shigenobu Suzuki, Toshinobu Kubota, Hitoshi Ishikawa, Atsushi Mizota

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引用次数: 0

Abstract

Purpose: This study aimed to evaluate the long-term results of carbon ion radiation therapy (CIRT) for choroidal malignant melanoma (CMM), especially regarding the preservation of the eye and visual acuity (VA).

Methods and materials: A total of 250 patients with intraocularly localized CMM treated with CIRT between January 2003 and September 2021 were included. The dose prescription included 60 to 85 Gy/4 to 5 fr, with only 68 Gy/4 fr used from 2018 onward. The rotating gantry system with scanning beams was introduced in April 2018. Adverse events (AEs) were graded according to the Common Terminology Criteria for AEs (version 5.0.). For secondary glaucoma, tumor-related visual field defects were excluded from the evaluation. For VA, 245 patients with VA ≥ light perception (LP) were followed up. Effective VA (≥20/200, Snellen equivalent), counting fingers, and LP were used as indicators.

Results: The median age was 55 (15-86) years. The T categories 1, 2, 3, and 4 were observed in 16 (6.4%), 41 (16.4%), 189 (75.6%), and 4 (1.6%) patients, respectively. With a median follow-up of 72.5 months, the 5- and 8-year overall survival rates were 87.5% and 84.2%, respectively; the 5- and 8-year local control rates were 94.4% and 92.9%, respectively. At the last follow-up, 19 of 250 patients (7.6%) underwent enucleation, 15 caused by local recurrence and 4 caused by AEs. Secondary glaucoma grades 1, 2, and 3 to 4 were observed in 22 (8.8%), 49 (19.6%), and 5 (2.0%) of patients, respectively. At the last follow-up, ≥ effective VA, ≥ counting fingers, and ≥ LP were maintained in 80 (33%), 120 (49%), and 154 (63%) of patients, respectively. Preservation rate of ≥ LP vision at 5 and 8 years after CIRT was 65.7% and 55.3%, respectively.

Conclusions: CIRT for CMM is a promising treatment for both tumor control and preservation of the eye and VA.

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脉络膜恶性黑色素瘤碳离子放射治疗后眼部和视力保护的长期效果。

目的：本研究旨在评估碳离子放疗（CIRT）治疗脉络膜恶性黑色素瘤（CMM）的长期效果，尤其是在保护眼球和视力（VA）方面：2003年1月至2021年9月期间，共有250名眼球内局部CMM患者接受了CIRT治疗。剂量处方包括60-85 Gy/4-5 fr，从2018年起仅使用68 Gy/4 fr。2018年4月引入了带扫描光束的旋转龙门系统。不良事件（AEs）根据AEs通用术语标准（5.0版）进行分级。对于继发性青光眼，肿瘤相关视野缺损不在评估范围内。在VA方面，对245名VA≥光感（LP）的患者进行了随访。有效视力（EV：≥ 20/200，斯奈伦等效视力）、数指（CF）和光感（LP）被作为指标：中位年龄为 55（15-86）岁。分别有 16（6.4%）、41（16.4%）、189（75.6%）和 4（1.6%）名患者属于 T-1、2、3 和 4 类。中位随访时间为 72.5 个月，5 年和 8 年总生存率分别为 87.5% 和 84.2%；5 年和 8 年局部控制率分别为 94.4% 和 92.9%。在最后一次随访中，250 名患者中有 19 人（7.6%）接受了去核手术，其中 15 人是由于局部复发，4 人是由于不良反应。继发性青光眼分 1 级、2 级和 3-4 级的患者分别有 22 人（8.8%）、49 人（19.6%）和 5 人（2.0%）。在最后一次随访中，分别有 80 例（33%）、120 例（49%）和 154 例（63%）患者保持≥EV、≥CF 和≥LP。CIRT术后5年和8年的≥LP视力保持率分别为65.7%和55.3%：CMM的CIRT是一种很有前景的治疗方法，既能控制肿瘤，又能保护眼球和视力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Radiation Oncology Biology Physics 医学-核医学

CiteScore

11.00

自引率

7.10%

发文量

2538

审稿时长

6.6 weeks

期刊介绍： International Journal of Radiation Oncology • Biology • Physics (IJROBP), known in the field as the Red Journal, publishes original laboratory and clinical investigations related to radiation oncology, radiation biology, medical physics, and both education and health policy as it relates to the field. This journal has a particular interest in original contributions of the following types: prospective clinical trials, outcomes research, and large database interrogation. In addition, it seeks reports of high-impact innovations in single or combined modality treatment, tumor sensitization, normal tissue protection (including both precision avoidance and pharmacologic means), brachytherapy, particle irradiation, and cancer imaging. Technical advances related to dosimetry and conformal radiation treatment planning are of interest, as are basic science studies investigating tumor physiology and the molecular biology underlying cancer and normal tissue radiation response.