{Reference Type}: Journal Article
{Title}: Comparison of stereotactic radiotherapy and protons for uveal melanoma patients.
{Author}: Fleury E;Pignol JP;Kiliç E;Milder M;van Rij C;Naus N;Yavuzyigitoglu S;den Toom W;Zolnay A;Spruijt K;van Vulpen M;Trnková P;Hoogeman M;
{Journal}: Phys Imaging Radiat Oncol
{Volume}: 31
{Issue}: 0
{Year}: 2024 Jul
暂无{DOI}: 10.1016/j.phro.2024.100605
{Abstract}: <B>UNASSIGNED: </B>Uveal melanoma (UM) is the most common primary ocular malignancy. We compared fractionated stereotactic radiotherapy (SRT) with proton therapy, including toxicity risks for UM patients.<BR><B>UNASSIGNED: </B>For a total of 66 UM patients from a single center, SRT dose distributions were compared to protons using the same planning CT. Fourteen dose-volume parameters were compared in 2-Gy equivalent dose per fraction (EQD2). Four toxicity profiles were evaluated: maculopathy, optic-neuropathy, visual acuity impairment (Profile I); neovascular glaucoma (Profile II); radiation-induced retinopathy (Profile III); and dry-eye syndrome (Profile IV). For Profile III, retina Mercator maps were generated to visualize the geographical location of dose differences.<BR><B>UNASSIGNED: </B>In 9/66 cases, (14 %) proton plans were superior for all dose-volume parameters. Higher T stages benefited more from protons in Profile I, especially tumors located within 3 mm or less from the optic nerve. In Profile II, only 9/66 cases resulted in a better proton plan. In Profile III, better retina volume sparing was always achievable with protons, with a larger gain for T3 tumors. In Profile IV, protons always reduced the risk of toxicity with a median RBE-weighted EQD2 reduction of 15.3 Gy.<BR><B>UNASSIGNED: </B>This study reports the first side-by-side imaging-based planning comparison between protons and SRT for UM patients. Globally, while protons appear almost always better regarding the risk of optic-neuropathy, retinopathy and dry-eye syndrome, for other toxicity like neovascular glaucoma, a plan comparison is warranted. Choice would depend on the prioritization of risks.