What is Proton Therapy

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Ocular (Uveal) Melanoma Treatment

Melanoma of the Eye

Ocular melanomas are the most common type of eye tumors. Historically, melanomas of the eye were treated by completely removing the eye. Since the mid-1970s, however, proton therapy has been used to treat melanoma of the eye without removing the eye and with less damage to the cornea, lens, retina, fovea, or optic nerve. Studies show that patients treated with protons have long-term survival rates equal to that of patients who have had an eye removed. Furthermore, most patients in these studies have retained useful vision in the treated eye.

Treatment Options for Ocular Cancers

The recommended treatment for eye tumors is based on the location and the size of the tumor. There are four treatment approaches for ocular melanoma.

Laser

If the tumor is small, laser treatment is sometimes an option.

Surgical enucleation (removal of the eye)

This is usually required if the tumor is very large. Outcomes are excellent for tumor control, but the side effect is the loss of the eye. For additional details, contact an ocular oncologist.

Brachytherapy

A large comparative study of patients with medium-size tumors found that brachytherapy was a good equivalent option to enucleation. It is now routinely used to treat all but the largest tumors and reservation of the eye is a priority.

Proton Therapy

Proton therapy is comparative in outcomes to brachytherapy and enucleation. Proton therapy is very effective in achieving local control of the melanoma, and does not worsen survival rates for the patient. It can be used to treat tumors too large for brachytherapy and is well suited to treating tumors next to the optic nerve. Ocular melanoma is one of the earliest uses of proton therapy and has been used to treat ocular cancers in the United States since 1994.

Protons can be controlled with greater precision than X-rays. This means that more energy goes into destroying the tumor and less radiation is delivered to surrounding healthy tissue. For this reason, proton therapy is particularly good for treating tumors near healthy organs, including melanoma of the eye.

In the left-hand image above, you can see a typical proton beam treatment plan for ocular cancer. The right-hand image shows typical treatment with X-rays.

 

Additional Resources:

Proton Therapy for Ocular Cancers

To read a ocular cancer survivor story, please click here.

Lung Cancer; Prostate Cancer; Ocular Cancers

“In order to be successful in caring for the patient, a partnership must be forged between the oncologist and the patient, with each contributing to the development of a treatment plan that speaks to all of the needs of the patient.”

Related Studies

Long-term Risk of Melanoma-Related Mortality for Patients With Uveal Melanoma Treated With Proton Beam Therapy Lane AM, Kim IK, Gragoudas ES Read Study
Intraocular collision tumour: case report and literature review Coupland SE, Dodson A, Liu H, Du MQ, Angi M, Damato BE. Read Study
Imaging of retinal and choroidal vascular tumours Heimann H, Jmor F, Damato B. Read Study
Local recurrence after uveal melanoma proton beam therapy: recurrence types and prognostic consequences Caujolle JP, Paoli V, Chamorey E, Maschi C, Baillif S, Herault J, Gastaud P, Hannoun-Levi JM. Read Study