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16 september 2007: Bron: 1: Ophthalmic Res. 2006;38(5):255-60. Epub 2006 Jul 28. Links Comment in: Ophthalmic Res. 2006;38(5):248-50.

De combinatie bestraling met protonstraling en hyperthermie verbetert bij choroidale melanomen het resultaat. Er zou veel minder vaak een tweede enucleation nodig zijn, maar ik weet niet wat dit woord betekent. Vraag ik nog na. Hier het abstract van een gerandomiseerde studie bij 151 patienten.

Combined proton beam radiotherapy and transpupillary thermotherapy for large uveal melanomas: a randomized study of 151 patients. Desjardins L, Lumbroso-Le Rouic L, Levy-Gabriel C, Dendale R, Delacroix S, Nauraye C, Estève M, Plancher C, Asselain B. Institut Curie, Paris, France. laurence.desjardins@curie.net INTRODUCTION: Exudation from the tumour scar and glaucoma can be major problems after proton beam irradiation of uveal melanoma and can sometimes lead to secondary enucleation. We conducted a randomized study to determine whether systematic transpupillary thermotherapy (TTT) after proton beam radiotherapy could have a beneficial effect.

PATIENTS AND METHOD: Between February 1999 and April 2003, all the patients treated by proton beam radiotherapy for uveal melanomas >/=7 mm thick or >/=15 mm in diameter were included in this study after giving their informed consent. One half of the patients received proton beam radiotherapy alone (60 Gy in 4 fractions) and the other half received the same dose of proton beam radiotherapy followed by TTT at 1, 6 and 12 months. All the information concerning the initial tumour parameters, treatments and follow-up was recorded and a statistical analysis was performed. RESULTS: We randomized 151 patients. The median follow-up was 38 months. The 2 groups of patients were similar in terms of age, gender and tumour characteristics. The patients treated with TTT showed a greater reduction of tumour thickness (p = 0.06), less retinal detachment at the latest follow-up (p = 0.14) and a lower secondary enucleation rate (p = 0.02).

DISCUSSION: The present study is the first randomized analysis to demonstrate a significant decrease in the secondary enucleation rate in patients treated with TTT after proton beam radiotherapy. Further studies should be performed to determine whether TTT could be beneficial to smaller tumours and to define its optimal dose. Copyright (c) 2006 S. Karger AG, Basel. PMID: 16888407 [PubMed - indexed for MEDLINE] Related Links Combined plaque radiotherapy and transpupillary thermotherapy in choroidal melanoma: 5 years' experience. [Br J Ophthalmol. 2003] [Results of treating uveal melanoma with proton beam radiation: 10-year follow-up] [J Fr Ophtalmol. 2005] Proton beam radiotherapy for uveal melanoma: results of Curie Institut-Orsay proton therapy center (ICPO). [Int J Radiat Oncol Biol Phys. 2006] [Treatment of uveal melanoma with iodine 125 plaques or proton beam therapy: indications and comparison of local recurrence rates] [J Fr Ophtalmol. 2003] Estimates of ocular and visual retention following treatment of extra-large uveal melanomas by proton beam radiotherapy. [Arch Ophthalmol. 2006] See all Related Articles...

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