Complications after proton therapy of choroidal melanoma: A case report

Authors

  • Natalia Kuková Vikom ophthalmology center
  • Maria Molnarova Vikom ophthalmology center
  • Jana Stefanickova Comenius University

DOI:

https://doi.org/10.31288/oftalmolzh202355659

Keywords:

choroidal melanoma, proton therapy, complications

Abstract

Proton beam therapy is a globe preserving treatment method of choroidal melanoma. It is considered to be less harmful for the tissues around the tumour but the complications such as radiation retinopathy and neuropathy occur according to the dosage of irradiation. The visual outcomes after treatment are variable and dependent on the size of tumour.

This article presents a case report of a 44-year-old male with choroidal melanoma in the left eye. Patient was examined in our ophthalmology practice because of photopsia and blurry vision during physical activity. After full ophthalmologic examination, fundus photography, optic coherent tomography, fluoresceine angiography and ultrasonography the diagnosis of malignant melanoma of choroid was set. The patient was referred to a proton center to undergo a proton therapy of choroidal melanoma in the left eye. Follow-up treatment of severe postradiation retinopathy and neuropathy is presented in the article. The patient took intravitreal bevacizumab injections and the panretinal lasercoagulation was performed. After one and half year follow up the melanoma is stable after therapy with no metastases.

References

Chattopadhyay C, Kim DW, Gombos DS, Oba J, Qin Y, Williams MD, et al. Uveal melanoma: From diagnosis to treatment and the science in between. Cancer. 2016 Aug 1;122(15):2299-312. https://doi.org/10.1002/cncr.29727

Damato B, Kacperek A, Errington D, Heimann H. Proton beam radiotherapy of uveal melanoma. Saudi journal of ophthalmology : official journal of the Saudi Ophthalmological Society. 2013; 27(3), 151-157. https://doi.org/10.1016/j.sjopt.2013.06.014

Espensen CA, Kiilgaard JF, Appelt AL, Fog LS, Herault J, Maschi C, Caujolle JP, Thariat J. Dose-Response and Normal Tissue Complication Probabilities after Proton Therapy for Choroidal Melanoma. Ophthalmology. 2021 Jan;128(1):152-161. https://doi.org/10.1016/j.ophtha.2020.06.030

Finger PT. Radiation retinopathy is treatable with anti-vascular endothelial growth factor bevacizumab (Avastin). Int J Radiat Oncol Biol Phys. 2008 Mar 15;70(4):974-7. https://doi.org/10.1016/j.ijrobp.2007.11.045

Gündüz K, Shields CL, Shields JA, Cater J, Freire JE, Brady LW. Radiation Retinopathy Following Plaque Radiotherapy for Posterior Uveal Melanoma. Arch Ophthalmol. 1999;117(5):609-614. https://doi.org/10.1001/archopht.117.5.609

Kaliki S, Shields CL. Uveal melanoma: relatively rare but deadly cancer. Eye (Lond). 2017 Feb;31(2):241-257. https://doi.org/10.1038/eye.2016.275

Kim IK, Lane AM, Jain P, Awh C, Gragoudas ES. Ranibizumab for the Prevention of Radiation Complications in Patients Treated With Proton Beam Irradiation for Choroidal Melanoma. Trans Am Ophthalmol Soc. 2016 Aug;114:T2.

Lima B R., Singh A., Bevacizumab Therapy for Choroidal Melanoma. European Oncology & Haematology, 2012;8(2):101-4. https://doi.org/10.17925/EOH.2012.08.02.101

Mishra, K. K., & Daftari, I. K. Proton therapy for the management of uveal melanoma and other ocular tumors. Chinese clinical oncology. 2016; 5(4), https://doi.org/10.21037/cco.2016.07.06

Psomiadi A, Haas G, Edlinger M, Bechrakis NE, Blatsios G. Ultra-wide-field imaging of choroidal melanoma before and after proton beam radiation therapy. Eur J Ophthalmol. 2020 Nov;30(6):1397-1402. https://doi.org/10.1177/1120672119873210

Rusňák Š, Hecová L, Kasl Z, Sobotová M, Hauer L. Therapy of uveal melanoma A Review. Terapie uveálního melanomu přehled. Ceska a slovenska oftalmologie : casopis Ceske oftalmologicke spolecnosti a Slovenske oftalmologicke spolecnosti. 2020; 77(1), 1-13. https://doi.org/10.31348/2020/X10

Singh P., Singh A. Choroidal melanoma. Oman J Ophthalmol. 2012 Jan;5(1):3-9. https://doi.org/10.4103/0974-620X.94718

Terzidou C, Trivli A, Dalianis G, Apessou D, Spandidos DA, Goulielmos GN. Advanced choroidal melanoma with a desirable aesthetic outcome after enucleation: A case report. Oncology Letters. 2018; 16 (1): 511-514. https://doi.org/10.3892/ol.2018.8661

Toutée A, Angi M, Dureau S, Lévy-Gabriel C, Rouic LL, et al. Long-Term Visual Outcomes for Small Uveal Melanoma Staged T1 Treated by Proton Beam Radiotherapy. Cancers. 2019; 11(8), 1047. https://doi.org/10.3390/cancers11081047

Published

2023-11-01

How to Cite

1.
Kuková N, Molnarova M, Stefanickova J. Complications after proton therapy of choroidal melanoma: A case report. J.ophthalmol. (Ukraine) [Internet]. 2023 Nov. 1 [cited 2024 Nov. 22];(5):56-8. Available from: https://ua.ozhurnal.com/index.php/files/article/view/64