PO-0812: Long-term outcomes and toxicity after proton beam radiotherapy of large non-peripapillary choroidal melanoma

B. Weber, K. Paton, R. Ma, T. Pickles
2015 Radiotherapy and Oncology  
S408 3rd ESTRO Forum 2015 any treatment was 23 weeks vs. 9 weeks in pts with BSC, p<0.0001. In pts who received local treatment (8: surgery + 3: RT) median PPS was 51 vs. 21 weeks for CHT, p = 0.36. Median PPS for surgery was 51 weeks vs. 17 weeks for RT, p = 0.62. Pts with poor KPS (<60) at relapse did not benefit from local treatment as compared with CHT: median PPS for local treatment vs. CHT was 14 vs. 18 weeks, p = 0.81. Median PPS for poor KPS pts with BSC was 7 weeks. For the whole group
more » ... For the whole group of 84 pts, median OS from randomization was 35 weeks: 55 vs. 30 weeks in pts who received any treatment vs. BSC only, p < 0.0001. Conclusions: Our results suggest that an active therapeutic approach may be beneficial for selected elderly and/or frail pts with rGBM, compared to BSC alone. Re-surgery seems to be the most efficacious therapeutic option for rGBM in elderly pts with high KPS; in poor KPS pts there is no benefit of local treatment (surgery and/or RT) over CHT. PO-0812 Long-term outcomes and toxicity after proton beam radiotherapy of large non-peripapillary choroidal melanoma Purpose/Objective: To report on outcomes and toxicity after proton beam radiotherapy for large non-peripapillary choroidal melanoma considered unsuitable for other eyesparing therapies in Canada. Materials and Methods: We included patients with nonperipapillary tumors (>2mm from the optic disc) treated with proton therapy at TRIUMF, the only ocular proton therapy facility in Canada, from 1995-2013. A prospective database including patient, tumor, and treatment characteristics was updated with ocular complications and follow up status from chart reviews. Results: In total, 77 patients were included in the analysis. The median age was 60 years and the median observation time 47 months (0-221 months). More than half of the patients (53%) had a tumor located anterior to the equator and 35% had involvement of the ciliary body. The median tumor diameter was 13.6 mm and the median thickness was 7.1 mm. The 5 -(10) year actuarial rate was 85 (85)% for ocular tumor control, 72 (57)% for metastasis-free survival, 77 (63)% for overall survival, 22 (22)% for enucleation and 38 (38)% for complete blindness. 80% of patients with blindness had developed neovascular glaucoma. For patients with good vision (≥20/50) at baseline, the 5-(10) year actuarial rate was 40 (40)% for conservation of vision of 20/50 or better, 44 (44)% for conservation of vision of 20/200 or better and 67 (67)% for conservation of vision of counting fingers or better. On univariate analysis, patients with ciliary body involvement had significant worse metastasis-free survival and overall survival rates compared to patients without ciliary body involvement (p<0.001). Conclusions: Proton therapy resulted in acceptable local control and survival rates in patients with large anteriorly located tumors. The risk of complete blindness and severe toxicity requiring enucleation was low and a substantial proportion maintained a useful vision.
doi:10.1016/s0167-8140(15)40804-7 fatcat:rnnfvfq3gvfmvi6vb4qvkwwzdm