Intraocular inflammation after proton beam irradiation for uveal melanoma

AIM To describe the inflammatory reaction that can occur following proton beam irradiation of uveal melanomas based on a large series of patients and to try to determine the risk factors for this reaction. METHODS Data from a cohort of patients with uveal melanoma treated by proton beam irradiation...

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Bibliographic Details
Published in:	British journal of ophthalmology Vol. 85; no. 11; pp. 1305 - 1308
Main Authors:	Lumbroso, Livia, Desjardins, Laurence, Levy, Christine, Plancher, Corine, Frau, Eric, D'Hermies, François, Schlienger, Pierre, Mammar, Hamin, Delacroix, Sabine, Nauraye, Catherine, Ferrand, Régis, Desblancs, Claire, Mazal, Alexandre, Asselain, Bernard
Format:	Journal Article
Language:	English
Published:	BMA House, Tavistock Square, London, WC1H 9JR BMJ Publishing Group Ltd 01-11-2001 BMJ BMJ Publishing Group LTD
Subjects:	Analysis of Variance Anti-Inflammatory Agents - therapeutic use Biological and medical sciences Care and treatment Complications and side effects Diseases of the eye Eye cancer Female Humans Injuries intraocular inflammation Intraocular lenses Irradiation Male Medical sciences Melanoma - complications Melanoma - pathology Melanoma - radiotherapy Mydriatics - therapeutic use Proportional Hazards Models proton beam irradiation Proton beams Radiation Injuries - complications Radiation Injuries - drug therapy Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Retrospective Studies Risk Factors Scientific Correspondence Steroids Survival Analysis Treatment Outcome uveal melanoma Uveal Neoplasms - complications Uveal Neoplasms - pathology Uveal Neoplasms - radiotherapy Uveitis, Anterior - drug therapy Uveitis, Anterior - etiology United Kingdom Human Intraocular Instrumentation therapy Uvea disease Inflammation Malignant tumor Radiotherapy Eye Eye disease Proton beam Treatment Uvea Risk factor Malignant melanoma Complication Evolution
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Summary:	AIM To describe the inflammatory reaction that can occur following proton beam irradiation of uveal melanomas based on a large series of patients and to try to determine the risk factors for this reaction. METHODS Data from a cohort of patients with uveal melanoma treated by proton beam irradiation between 1991 and 1994 were analysed. The presence of inflammation was recorded and evaluated. Kaplan-Meier estimates and statistical analysis of general and tumour related risk factors were performed. RESULTS 28% of patients treated during this period presented with ocular inflammation (median follow up 62 months). Risks factors were essentially tumour related and were correlated with larger lesions (height > 5 mm, diameter > 12 mm, volume > 0.4 cm3). Multivariate analysis identified initial tumour height and irradiation of a large volume of the eye as the two most important risk factors. Ocular inflammation usually consisted of mild anterior uveitis, resolving rapidly after topical steroids and cycloplegics. The incidence of inflammation after proton beam irradiation of melanomas seems higher than previously reported and is related to larger lesions. Evidence of inflammation associated with uveal melanoma has been described and seems to be associated with tumour necrosis (spontaneous or after irradiation). The appearance of transient inflammation during the follow up of these patients may be related to the release of inflammatory cytokines during tumour necrosis. CONCLUSION Inflammation following proton beam irradiation is not unusual. It is correlated with larger initial tumours and may be related to tumour necrosis.
Bibliography:	href:bjophthalmol-85-1305.pdf ark:/67375/NVC-3LPS8S94-7 local:bjophthalmol;85/11/1305 istex:5D28A6517F9173098614363A6E7AA9C73B658188 PMID:11673294
ISSN:	0007-1161 1468-2079
DOI:	10.1136/bjo.85.11.1305