Feasibility, Method and Early Outcome of Image-Guided Volumetric Modulated Arc Radiosurgery Followed by Resection for AJCC Stage IIA–IIIB High-Risk Large Intraocular Melanoma
The main objective of this prospective observational study was the characterization of the feasibility and early outcome of image-guided (IG) volumetric modulated arc (VMAT) radiosurgery (SRS) followed by resection for patients with large intraocular melanoma. Our study included consecutive patients...
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MDPI AG
2022-09-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/14/19/4729 |
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| author | Maja Guberina Ekaterina Sokolenko Nika Guberina Sami Dalbah Christoph Pöttgen Wolfgang Lübcke Frank Indenkämpen Manfred Lachmuth Dirk Flühs Ying Chen Christian Hoffmann Cornelius Deuschl Leyla Jabbarli Miltiadis Fiorentzis Andreas Foerster Philipp Rating Melanie Ebenau Tobias Grunewald Nikolaos Bechrakis Martin Stuschke |
| author_facet | Maja Guberina Ekaterina Sokolenko Nika Guberina Sami Dalbah Christoph Pöttgen Wolfgang Lübcke Frank Indenkämpen Manfred Lachmuth Dirk Flühs Ying Chen Christian Hoffmann Cornelius Deuschl Leyla Jabbarli Miltiadis Fiorentzis Andreas Foerster Philipp Rating Melanie Ebenau Tobias Grunewald Nikolaos Bechrakis Martin Stuschke |
| author_sort | Maja Guberina |
| collection | DOAJ |
| description | The main objective of this prospective observational study was the characterization of the feasibility and early outcome of image-guided (IG) volumetric modulated arc (VMAT) radiosurgery (SRS) followed by resection for patients with large intraocular melanoma. Our study included consecutive patients with unfavorable-risk melanoma, enrolled in an ophthalmic oncology center. IG-VMAT-SRS was applied by high-resolution 4D image guidance and monitoring. Current stereotactic technique parameters were evaluated for comparison. Side effects and eye function, based on a 5-point CTC assessment score, were quantified. In patients with tumors located more than 0.7–1 mm apart from the optic nerve, partial to complete volume-sparing of the optic nerve head could be achieved. In 95.5% of this subgroup, the vitality of the optic nerve and vision could be preserved by the multimodality-treatment approach (mean follow-up: 18 months (7.5–36 months)). The advanced technology of stereotactic radiotherapy demonstrated the achievability of steep dose gradients around the high-dose volume, with 4D-IG-VMAT dose application. These results enforce IG-VMAT-SRS followed by resection as one of the major therapeutic options for patients with large intraocular melanoma. The combination of 4D-IG high-precision SRS and resection provides an effective treatment for large intraocular melanoma, with few side effects, and enables an eye bulb and even vision preserving modus operandi. |
| first_indexed | 2024-03-09T21:57:28Z |
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| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T21:57:28Z |
| publishDate | 2022-09-01 |
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| record_format | Article |
| series | Cancers |
| spelling | doaj.art-3d8db9b3fd364e82b07af9cd403a5ae02023-11-23T19:55:46ZengMDPI AGCancers2072-66942022-09-011419472910.3390/cancers14194729Feasibility, Method and Early Outcome of Image-Guided Volumetric Modulated Arc Radiosurgery Followed by Resection for AJCC Stage IIA–IIIB High-Risk Large Intraocular MelanomaMaja Guberina0Ekaterina Sokolenko1Nika Guberina2Sami Dalbah3Christoph Pöttgen4Wolfgang Lübcke5Frank Indenkämpen6Manfred Lachmuth7Dirk Flühs8Ying Chen9Christian Hoffmann10Cornelius Deuschl11Leyla Jabbarli12Miltiadis Fiorentzis13Andreas Foerster14Philipp Rating15Melanie Ebenau16Tobias Grunewald17Nikolaos Bechrakis18Martin Stuschke19Department of Radiotherapy, University Hospital Essen, West German Cancer Center, University Duisburg-Essen, Hufeland Str. 55, 45147 Essen, GermanyDepartment of Ophthalmology, University Hospital Essen, University of Duisburg-Essen, Hufeland Str. 55, 45147 Essen, GermanyDepartment of Radiotherapy, University Hospital Essen, West German Cancer Center, University Duisburg-Essen, Hufeland Str. 55, 45147 Essen, GermanyDepartment of Ophthalmology, University Hospital Essen, University of Duisburg-Essen, Hufeland Str. 55, 45147 Essen, GermanyDepartment of Radiotherapy, University Hospital Essen, West German Cancer Center, University Duisburg-Essen, Hufeland Str. 55, 45147 Essen, GermanyDepartment of Radiotherapy, University Hospital Essen, West German Cancer Center, University Duisburg-Essen, Hufeland Str. 55, 45147 Essen, GermanyDepartment of Radiotherapy, University Hospital Essen, West German Cancer Center, University Duisburg-Essen, Hufeland Str. 55, 45147 Essen, GermanyDepartment of Radiotherapy, University Hospital Essen, West German Cancer Center, University Duisburg-Essen, Hufeland Str. 55, 45147 Essen, GermanyDepartment of Radiotherapy, University Hospital Essen, West German Cancer Center, University Duisburg-Essen, Hufeland Str. 55, 45147 Essen, GermanyDepartment of Ophthalmology, University Hospital Essen, University of Duisburg-Essen, Hufeland Str. 55, 45147 Essen, GermanyDepartment of Radiotherapy, University Hospital Essen, West German Cancer Center, University Duisburg-Essen, Hufeland Str. 55, 45147 Essen, GermanyInstitute of Diagnostic, Interventional Radiology and Neuroradiology, University Hospital Essen, University Duisburg-Essen, 45147 Essen, GermanyDepartment of Ophthalmology, University Hospital Essen, University of Duisburg-Essen, Hufeland Str. 55, 45147 Essen, GermanyDepartment of Ophthalmology, University Hospital Essen, University of Duisburg-Essen, Hufeland Str. 55, 45147 Essen, GermanyDepartment of Ophthalmology, University Hospital Essen, University of Duisburg-Essen, Hufeland Str. 55, 45147 Essen, GermanyDepartment of Ophthalmology, University Hospital Essen, University of Duisburg-Essen, Hufeland Str. 55, 45147 Essen, GermanyDepartment of Radiotherapy, University Hospital Essen, West German Cancer Center, University Duisburg-Essen, Hufeland Str. 55, 45147 Essen, GermanyDepartment of Radiotherapy, University Hospital Essen, West German Cancer Center, University Duisburg-Essen, Hufeland Str. 55, 45147 Essen, GermanyDepartment of Ophthalmology, University Hospital Essen, University of Duisburg-Essen, Hufeland Str. 55, 45147 Essen, GermanyDepartment of Radiotherapy, University Hospital Essen, West German Cancer Center, University Duisburg-Essen, Hufeland Str. 55, 45147 Essen, GermanyThe main objective of this prospective observational study was the characterization of the feasibility and early outcome of image-guided (IG) volumetric modulated arc (VMAT) radiosurgery (SRS) followed by resection for patients with large intraocular melanoma. Our study included consecutive patients with unfavorable-risk melanoma, enrolled in an ophthalmic oncology center. IG-VMAT-SRS was applied by high-resolution 4D image guidance and monitoring. Current stereotactic technique parameters were evaluated for comparison. Side effects and eye function, based on a 5-point CTC assessment score, were quantified. In patients with tumors located more than 0.7–1 mm apart from the optic nerve, partial to complete volume-sparing of the optic nerve head could be achieved. In 95.5% of this subgroup, the vitality of the optic nerve and vision could be preserved by the multimodality-treatment approach (mean follow-up: 18 months (7.5–36 months)). The advanced technology of stereotactic radiotherapy demonstrated the achievability of steep dose gradients around the high-dose volume, with 4D-IG-VMAT dose application. These results enforce IG-VMAT-SRS followed by resection as one of the major therapeutic options for patients with large intraocular melanoma. The combination of 4D-IG high-precision SRS and resection provides an effective treatment for large intraocular melanoma, with few side effects, and enables an eye bulb and even vision preserving modus operandi.https://www.mdpi.com/2072-6694/14/19/4729image-guidedvolumetric modulated arc radiotherapyradiosurgeryendoresectiontranscleral resectionlarge intraocular melanoma |
| spellingShingle | Maja Guberina Ekaterina Sokolenko Nika Guberina Sami Dalbah Christoph Pöttgen Wolfgang Lübcke Frank Indenkämpen Manfred Lachmuth Dirk Flühs Ying Chen Christian Hoffmann Cornelius Deuschl Leyla Jabbarli Miltiadis Fiorentzis Andreas Foerster Philipp Rating Melanie Ebenau Tobias Grunewald Nikolaos Bechrakis Martin Stuschke Feasibility, Method and Early Outcome of Image-Guided Volumetric Modulated Arc Radiosurgery Followed by Resection for AJCC Stage IIA–IIIB High-Risk Large Intraocular Melanoma Cancers image-guided volumetric modulated arc radiotherapy radiosurgery endoresection transcleral resection large intraocular melanoma |
| title | Feasibility, Method and Early Outcome of Image-Guided Volumetric Modulated Arc Radiosurgery Followed by Resection for AJCC Stage IIA–IIIB High-Risk Large Intraocular Melanoma |
| title_full | Feasibility, Method and Early Outcome of Image-Guided Volumetric Modulated Arc Radiosurgery Followed by Resection for AJCC Stage IIA–IIIB High-Risk Large Intraocular Melanoma |
| title_fullStr | Feasibility, Method and Early Outcome of Image-Guided Volumetric Modulated Arc Radiosurgery Followed by Resection for AJCC Stage IIA–IIIB High-Risk Large Intraocular Melanoma |
| title_full_unstemmed | Feasibility, Method and Early Outcome of Image-Guided Volumetric Modulated Arc Radiosurgery Followed by Resection for AJCC Stage IIA–IIIB High-Risk Large Intraocular Melanoma |
| title_short | Feasibility, Method and Early Outcome of Image-Guided Volumetric Modulated Arc Radiosurgery Followed by Resection for AJCC Stage IIA–IIIB High-Risk Large Intraocular Melanoma |
| title_sort | feasibility method and early outcome of image guided volumetric modulated arc radiosurgery followed by resection for ajcc stage iia iiib high risk large intraocular melanoma |
| topic | image-guided volumetric modulated arc radiotherapy radiosurgery endoresection transcleral resection large intraocular melanoma |
| url | https://www.mdpi.com/2072-6694/14/19/4729 |
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