Lens-sparing external beam radiotherapy of intraocular metastases: Our experiences with twenty four eyes

A. Bajcsay, G. Kontra, Z. Récsán, J. Tóth, J. Fodor

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Occurrence of uveal metastases is higher, than the number of clinically diagnosed cases, furthermore all cases are not amenable to therapy. Treatment of primary cancer is permanently improving, as a result life prospective is better, with an increasing number of late distant metastases in an unusual location, as e.g. intraocular metastasis. As surgical approach is not suitable, and chemo/hormonal therapy often has a limited effect on intraocular dissemination, other treatment modalities are needed for the maintenance of visual acuity, and prevention of further deterioration of the quality of life. The study was made to evaluate the efficacy of external beam radiotherapy (EBRT) with lens-sparing techniques in the management of patients developing intraocular metastases (IOM). Between March 1994 and March 2002, 24 eyes of 17 patients with tumors metastatic to the eye were treated by EBRT. The female: male ratio was 8.5:1, age ranged between 37 and 74 years (mean: 56 years). The site of the primary tumor was: breast (11), lung (4) and others (2). The visual acuity at the beginning of irradiation was between 0.1-0.7 (mean 0.5) and a mean KPS of 60% was detected. The mean time elapsed from the diagnosis of primary tumor and recognition of metastasis was 38.9 months in case of breast, and 6.7 months in lung cancer. Eyes were treated by 6 MV photon beams, using a modified technique of Schipper's lens-sparing retinoblastoma treatment method. The following parameters were studied: visual acuity changes, local response rate, survival times from irradiation and ocular complications. Mean follow-up time was 24 months. Mean visual acuity improved two lines on the Snellen chart. The mean survival time after treatment of IOM was 21 months in breast and 4.9 months in lung cancer patients. Local response rate was 78%. No radiation cataract was observed. Only one patient developed radiation retinopathy 32 months after the treatment. External beam radiotherapy is recommended for the treatment of intraocular metastases to improve quality of life. In selected cases - especially breast cancer patients - lens-sparing technique is the treatment of choice.

Original languageEnglish
Pages (from-to)459-464
Number of pages6
JournalNeoplasma
Volume50
Issue number6
Publication statusPublished - 2003

Fingerprint

Lenses
Radiotherapy
Neoplasm Metastasis
Visual Acuity
Therapeutics
Lung Neoplasms
Breast
Survival Rate
Quality of Life
Radiation
Breast Neoplasms
Neoplasms
Retinoblastoma
Photons
Cataract
Maintenance
Lung

Keywords

  • Eye
  • Intraocular metastasis
  • Lens-sparing radiotherapy technique

ASJC Scopus subject areas

  • Cancer Research

Cite this

Lens-sparing external beam radiotherapy of intraocular metastases : Our experiences with twenty four eyes. / Bajcsay, A.; Kontra, G.; Récsán, Z.; Tóth, J.; Fodor, J.

In: Neoplasma, Vol. 50, No. 6, 2003, p. 459-464.

Research output: Contribution to journalArticle

@article{6ecb8b604285404cbf2467885d6856ae,
title = "Lens-sparing external beam radiotherapy of intraocular metastases: Our experiences with twenty four eyes",
abstract = "Occurrence of uveal metastases is higher, than the number of clinically diagnosed cases, furthermore all cases are not amenable to therapy. Treatment of primary cancer is permanently improving, as a result life prospective is better, with an increasing number of late distant metastases in an unusual location, as e.g. intraocular metastasis. As surgical approach is not suitable, and chemo/hormonal therapy often has a limited effect on intraocular dissemination, other treatment modalities are needed for the maintenance of visual acuity, and prevention of further deterioration of the quality of life. The study was made to evaluate the efficacy of external beam radiotherapy (EBRT) with lens-sparing techniques in the management of patients developing intraocular metastases (IOM). Between March 1994 and March 2002, 24 eyes of 17 patients with tumors metastatic to the eye were treated by EBRT. The female: male ratio was 8.5:1, age ranged between 37 and 74 years (mean: 56 years). The site of the primary tumor was: breast (11), lung (4) and others (2). The visual acuity at the beginning of irradiation was between 0.1-0.7 (mean 0.5) and a mean KPS of 60{\%} was detected. The mean time elapsed from the diagnosis of primary tumor and recognition of metastasis was 38.9 months in case of breast, and 6.7 months in lung cancer. Eyes were treated by 6 MV photon beams, using a modified technique of Schipper's lens-sparing retinoblastoma treatment method. The following parameters were studied: visual acuity changes, local response rate, survival times from irradiation and ocular complications. Mean follow-up time was 24 months. Mean visual acuity improved two lines on the Snellen chart. The mean survival time after treatment of IOM was 21 months in breast and 4.9 months in lung cancer patients. Local response rate was 78{\%}. No radiation cataract was observed. Only one patient developed radiation retinopathy 32 months after the treatment. External beam radiotherapy is recommended for the treatment of intraocular metastases to improve quality of life. In selected cases - especially breast cancer patients - lens-sparing technique is the treatment of choice.",
keywords = "Eye, Intraocular metastasis, Lens-sparing radiotherapy technique",
author = "A. Bajcsay and G. Kontra and Z. R{\'e}cs{\'a}n and J. T{\'o}th and J. Fodor",
year = "2003",
language = "English",
volume = "50",
pages = "459--464",
journal = "Neoplasma",
issn = "0028-2685",
publisher = "Vydavatel'stvo Slovenkej Akademie Vied/Veda Publishing House of the Slovak Academy of Sciences",
number = "6",

}

TY - JOUR

T1 - Lens-sparing external beam radiotherapy of intraocular metastases

T2 - Our experiences with twenty four eyes

AU - Bajcsay, A.

AU - Kontra, G.

AU - Récsán, Z.

AU - Tóth, J.

AU - Fodor, J.

PY - 2003

Y1 - 2003

N2 - Occurrence of uveal metastases is higher, than the number of clinically diagnosed cases, furthermore all cases are not amenable to therapy. Treatment of primary cancer is permanently improving, as a result life prospective is better, with an increasing number of late distant metastases in an unusual location, as e.g. intraocular metastasis. As surgical approach is not suitable, and chemo/hormonal therapy often has a limited effect on intraocular dissemination, other treatment modalities are needed for the maintenance of visual acuity, and prevention of further deterioration of the quality of life. The study was made to evaluate the efficacy of external beam radiotherapy (EBRT) with lens-sparing techniques in the management of patients developing intraocular metastases (IOM). Between March 1994 and March 2002, 24 eyes of 17 patients with tumors metastatic to the eye were treated by EBRT. The female: male ratio was 8.5:1, age ranged between 37 and 74 years (mean: 56 years). The site of the primary tumor was: breast (11), lung (4) and others (2). The visual acuity at the beginning of irradiation was between 0.1-0.7 (mean 0.5) and a mean KPS of 60% was detected. The mean time elapsed from the diagnosis of primary tumor and recognition of metastasis was 38.9 months in case of breast, and 6.7 months in lung cancer. Eyes were treated by 6 MV photon beams, using a modified technique of Schipper's lens-sparing retinoblastoma treatment method. The following parameters were studied: visual acuity changes, local response rate, survival times from irradiation and ocular complications. Mean follow-up time was 24 months. Mean visual acuity improved two lines on the Snellen chart. The mean survival time after treatment of IOM was 21 months in breast and 4.9 months in lung cancer patients. Local response rate was 78%. No radiation cataract was observed. Only one patient developed radiation retinopathy 32 months after the treatment. External beam radiotherapy is recommended for the treatment of intraocular metastases to improve quality of life. In selected cases - especially breast cancer patients - lens-sparing technique is the treatment of choice.

AB - Occurrence of uveal metastases is higher, than the number of clinically diagnosed cases, furthermore all cases are not amenable to therapy. Treatment of primary cancer is permanently improving, as a result life prospective is better, with an increasing number of late distant metastases in an unusual location, as e.g. intraocular metastasis. As surgical approach is not suitable, and chemo/hormonal therapy often has a limited effect on intraocular dissemination, other treatment modalities are needed for the maintenance of visual acuity, and prevention of further deterioration of the quality of life. The study was made to evaluate the efficacy of external beam radiotherapy (EBRT) with lens-sparing techniques in the management of patients developing intraocular metastases (IOM). Between March 1994 and March 2002, 24 eyes of 17 patients with tumors metastatic to the eye were treated by EBRT. The female: male ratio was 8.5:1, age ranged between 37 and 74 years (mean: 56 years). The site of the primary tumor was: breast (11), lung (4) and others (2). The visual acuity at the beginning of irradiation was between 0.1-0.7 (mean 0.5) and a mean KPS of 60% was detected. The mean time elapsed from the diagnosis of primary tumor and recognition of metastasis was 38.9 months in case of breast, and 6.7 months in lung cancer. Eyes were treated by 6 MV photon beams, using a modified technique of Schipper's lens-sparing retinoblastoma treatment method. The following parameters were studied: visual acuity changes, local response rate, survival times from irradiation and ocular complications. Mean follow-up time was 24 months. Mean visual acuity improved two lines on the Snellen chart. The mean survival time after treatment of IOM was 21 months in breast and 4.9 months in lung cancer patients. Local response rate was 78%. No radiation cataract was observed. Only one patient developed radiation retinopathy 32 months after the treatment. External beam radiotherapy is recommended for the treatment of intraocular metastases to improve quality of life. In selected cases - especially breast cancer patients - lens-sparing technique is the treatment of choice.

KW - Eye

KW - Intraocular metastasis

KW - Lens-sparing radiotherapy technique

UR - http://www.scopus.com/inward/record.url?scp=0346363805&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0346363805&partnerID=8YFLogxK

M3 - Article

C2 - 14689070

AN - SCOPUS:0346363805

VL - 50

SP - 459

EP - 464

JO - Neoplasma

JF - Neoplasma

SN - 0028-2685

IS - 6

ER -