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HAMBURG — Proton beam irradiation has been a major breakthrough in the treatment of uveal melanoma, overcoming several limitations of previous systems and providing tumor control over 10 years in 98% of cases, a speaker said here.
Leonidas Zografos, MD, this year’s Euretina Medal Lecturer, said that since the introduction of proton beam irradiation in the United States in 1975 and in Europe in 1984, about 25,000 to 30,000 uveal melanoma cases have been treated in more than 10 major units worldwide with this modality.
"More than 6,000 cases have been performed since 1984 in our center alone," he said.
Proton beam irradiation uses a computerized eye model to localize the affected area and create a customized treatment pattern that reproduces exactly the size and shape of the tumor. Targeted, low-level irradiation is delivered, preserving the surrounding tissue.
Proton beam irradiation in uveal melanoma is associated with a low recurrence rate of 1.2%, and high eye retention probability of 95.6%.
"As ophthalmologists, we aim at preventing recurrence, which leads to shorter life expectancy. Recurrence within the first 2 years is correlated with a mortality rate of almost 75%," he said.
Future challenges include reduction of mortality rate, reduction of radiation-induced side effects and preservation of the low recurrence rate, Zografos said.
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