Three years of ocular proton therapy in the Netherlands, clinical results.
Retinal detachment was the most common side effect after proton therapy for uveal melanoma.
Three years of ocular proton therapy in the Netherlands, clinical results.
The purpose of this study is to assess the oncological and ophthalmological outcomes of the current cohort and compare with the published historic cohort.
All consecutive patients with proton therapy for uveal melanoma from January 2020 till 31st December 2023 (n = 176) and the Historic Cohort (n = 101) were treated with 4 × 15 Cobalt Gray Equivalent and were included.
The median age in the current cohort was 65 years (Historic: 59, p = 0.001).
Tumour stage differed between the cohorts T1 current 10% (historic 3%), T2 21% (26%), T3 55% (36%), T4 14% (36%) (p = 0.004).
At 3 years, OS was 78.9% (86%), DM 26.6% (17%), LF 3.5% (6%) and enucleation rate 16.8% (19%), the latter mostly because of pain and/or retinal detachment.
In both cohorts, visual acuity dropped substantially after treatment (median -0.50).
The establishment of the HollandPTC improves access to proton therapy for Dutch uveal melanoma patients and results in additional sparing of around 40 eyes per year.
Tumour regression after treatment happened gradually from 3 months to 2-3 years, often leaving a rest behind of 3-5 mm. Tumour control, eye preservation rates, and side effects are similar to the published historic cohort treated abroad.