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September 1978

Proton Irradiation of Choroidal Melanomas: Preliminary Results

Author Affiliations

From the Eye Research Institute of Retina Foundation and the Massachusetts Eye and Ear Infirmary (Drs Gragoudas, Brockhurst, and Constable), the Department of Radiation Medicine, Massachusetts General Hospital (Drs Goitein, Verhey, Tepper, and Suit), and Harvard University Cyclotron Laboratory (Mr Koehler, Mr Wagner, Dr Schneider, and Ms Johnson). Dr Constable is now with the University of Western Australia, Perth.

Arch Ophthalmol. 1978;96(9):1583-1591. doi:10.1001/archopht.1978.03910060217006

• Choroidal malignant melanomas in nine patients were treated with proton beam irradiation at the Harvard Cyclotron Laboratory, Cambridge, Mass. Each patient received five proton beam treatments in eight to ten days, totaling 4,730 to 8,570 rads at the tumor. No complications occurred during the treatment or followup period, which, at the time of this writing, ranges from one to 24 months, with an average of 12 months. No further growth of the tumor has been observed in any patient. Different signs of tumor regression have been noted. Resolution of the serous retinal detachments that accompanied some tumors is the earliest finding. Pigment changes over the surface of the tumor and adjacent pigment epithelium is a usual initial tumor response. Fluorescein angiography initially showed decreased leakage of dye; later, destruction of the tumor's vasculature and elimination of fluorescein leakage became evident. Only large choroidal vessels remained patent. Ultrasonography revealed decreased height of the tumors postirradiation, and the radioactive phosphorus (32P) uptake test, repeated in one patient, turned negative on postirradiation measurements.

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