[Analysis of therapeutic effects of proton and heavy ion radiotherapy on uveal melanoma].

Authors

H Yue, L Kong, W X Hu, B B Xu, J Guo, Y F Huang, Y W Bi, B Ping, R Jiang, K Xue, J Qian

Published in

[Zhonghua yan ke za zhi] Chinese journal of ophthalmology. Volume 62. Issue 9. Pages 710-720. Sep 11, 2026.

Abstract

Objective: To investigate the effectiveness and prognosis of uveal melanoma treated with proton or heavy ion therapy. Methods: A retrospective analysis was performed. We enrolled patients diagnosed with uveal melanoma at the Department of Ophthalmology, Eye & ENT Hospital of Fudan University between 2015 and 2020 and receiving proton beam therapy overseas, as well as patients diagnosed with uveal melanoma and treated with heavy ion radiotherapy at the Department of Ophthalmology, Eye & ENT Hospital of Fudan University and the Department of Radiotherapy, Shanghai Proton and Heavy Ion Center from July 2020 to August 2025. Patients' information was collected, including the gender, age, best-corrected visual acuity and its changes, largest basal diameter and thickness of the tumor and their changes, tumor stage, radiotherapy type and complications, supplementary treatments after radiotherapy, and follow-up duration and modalities. The t-test was used to compare the changes in tumor diameter and thickness before and after radiotherapy. The local control rate of the tumor was summarized. Survival curves were drawn. The Kaplan-Meier product-limit method was used to calculate the cumulative metastasis-free survival rate and cumulative eye preservation rate at 3 and 5 years. Results: A total of 69 patients (69 eyes) were included. There were 31 males (44.9%) and 38 females (55.1%), with an average age of (46.5±12.2) years. The tumor stage (tumor-lymph node-distant metastasis staging system) was mainly T2 (33/69, 47.8%) and T3 stage (23/69, 33.3%). Twelve patients (17.4%) received proton radiotherapy, and 57 patients (82.6%) received heavy ion radiotherapy. The follow-up, which was conducted through outpatient visits and telephone interviews, lasted (40.2±31.8) months. The largest basal diameter of the tumor significantly decreased from (11.3±2.9) mm at baseline to (9.5±3.5) mm after radiotherapy, and the tumor thickness was reduced from (6.7±2.3) mm to (5.5±2.7) mm; both were statistically significant (both P<0.05). After treatment, 19 patients retained best-corrected visual acuity of≥0.1, and the major complications were radiation-induced retinopathy (29/69, 42.0%), macular edema (26/69, 37.7%), retinal detachment (24/69, 34.8%), and cataracts (23/69, 33.3%). Four patients (5.8%) ultimately underwent enucleation, including three cases due to neovascular glaucoma, and one case of anterior chamber seeding recurrence after local tumor resection. The local tumor control rate was 98.6% (68/69), and the 5-year cumulative eye preservation rate was 90.6%. In terms of survival prognosis, four patients had liver metastasis of the tumor, one patient had breast metastasis, and the 3-and 5-year cumulative metastasis-free survival rates were 93.7% and 90.3%, respectively. Conclusion: Both proton radiotherapy and heavy ion radiotherapy for uveal melanoma not only achieve high local tumor control and eye preservation rates with a favorable safety profile, but also help to preserve partial visual acuity, holding promising prospects.

PMID:
42706143
Bibliographic data and abstract were imported from PubMed on 08 Sep 2026.

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