eISSN: 1897-4309
ISSN: 1428-2526
Contemporary Oncology/Współczesna Onkologia
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SCImago Journal & Country Rank
2/2023
vol. 27
 
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abstract:
Case report

Photon-based high-dose single-fraction radiosurgery, an effective treatment modality for recurrent uveal melanoma

Concetta Laliscia
1
,
Federica Genovesi-Ebert
2
,
Franco Perrone
3
,
Taiusha Fuentes
1
,
Federica Cresti
2
,
Francesca Guido
2
,
Maria Tripodi
3
,
Fabiola Paiar
1

  1. Department of New Technologies and Translational Research, Division of Radiation Oncology, University Hospital of Pisa, Pisa, Italy
  2. Department of Ophthalmic Surgery, Division of Ophthalmic Surgery, University Hospital of Pisa, Pisa, Italy
  3. Department of Medical Physics, Division of Medical Physics, University Hospital of Pisa, Pisa, Italy
Contemp Oncol (Pozn) 2023; 27 (2):109 –112
Online publish date: 2023/07/12
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Introduction:
To evaluate and report the outcome of a patient with locally recurrent uveal melanoma (UM) previously treated with brachytherapy (BT), using a second personalized globe-sparing radiotherapy approach.

Material and methods:
In June 2020, a 78-year-old man arrived at our institution with diplopia and suspected uveal melanoma. At the ophthalmological evaluation (B-scan and A-scan ultrasonography) a lesion in the right eye at 6–7 hours of about 5 mm thickness, with internal lacunar areas, approximately 7 mm away from the limbus, was observed. The patient underwent ruthenium plaque BT at a total dose of 110 Gy prescribed to the apex of the tumour. At the follow-up, the lesion was under control until September 2021, but it recurred with a satellite exudative detachment in the lower and temporal sectors 7–10 hours. At the B-scan the lesion had a maximum thickness of 4.6 mm. Subsequently, in a multidisciplinary discussion, one single fraction stereotactic radiosurgery was scheduled. The prescribed dose was 27 Gy in the de-novo lesion and 24 Gy in the previously irradiated site. Stereotactic radiosurgery was performed in October 2021.

Results:
The time interval between the 2 treatments was 15 months. Twenty months after recurrence, local tumour control was observed, and no metastases were detected on follow-up examinations. No severe acute or late toxicity was observed due to the retreatment.

Conclusions:
Photon stereotactic radiotherapy is a feasible, acceptably tolerated modality, and it represents an eye-preserving treatment also for patients with recurrent UM unfit for BT.

keywords:

uveal melanoma, bra­chytherapy, intensity modulated radiotherapy, stereotactic body radiotherapy, eye preservation

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