Proton beam Irradiation using a light-field technique for the treatment of choroidal hemangiomas

Ivana K. Kim, R. V.Paul Chan, Yoshihiro Yonekawa, Anne Marie Lane, Dimitra Skondra, John E. Munzenrider, J. Michael Collier, Evangelos S. Gragoudas

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

Background/Aims: To describe the clinical outcomes of patients with circumscribed and diffuse choroidal hemangiomas treated by proton beam irradiation using a nonsurgical light-field technique. Methods: A retrospective chart review was performed on a series of 19 patients (19 eyes) with choroidal hemangiomas treated with proton beam therapy between July 1988 and August 2005. Choroidal hemangiomas were treated with proton beam irradiation using a light-field technique and doses ranging from 15 to 30 cobalt Gray equivalents (CGE; CGE = proton Gy × relative biological effectiveness 1.1) in 4 fractions. Patients with at least 6 months' follow-up were included in the study. Tumor regression, visual acuity, absorption of subretinal fluid, and treatment-associated complications were evaluated by clinical examination and ultrasonography. Results: Visual acuity improved or remained stable in 14 of 18 eyes (78%). Subretinal fluid was initially present in 16 of 19 eyes (84%), and completely resolved in all 16 eyes. Tumor height, as measured by B-scan ultrasonography, decreased in 18 of 19 eyes and remained stable in 1 of 19, as of the last examination. Complications of radiation developed in 9 of 19 eyes (47%) with the total applied dose ranging from 15 to 30 CGE for these 9 eyes. Conclusions: Proton beam irradiation using a light-field technique without surgical tumor localization is an effective treatment option in managing both circumscribed choroidal hemangiomas and diffuse hemangiomas associated with Sturge-Weber syndrome. A total proton dose as low as 15 CGE applied in 4 fractions appears to be sufficient to reduce tumor size, promote absorption of subretinal fluid, and improve or stabilize vision in most patients.

Original languageEnglish (US)
Pages (from-to)209-216
Number of pages8
JournalOphthalmologica
Volume224
Issue number4
DOIs
StatePublished - Jun 2010

Keywords

  • Choroidal hemangiomas
  • Light field technique
  • Proton beam irradiation

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems

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