By M.J. Jager, L. Desjardins, T. Kivelä, B.E. Damato, F. Bandello
Uveal cancer is an competitive type of melanoma which can contain the iris, the ciliary physique, and/or the choroid, that is the most place of this tumor. sufferers frequently desire to learn approximately therapy offerings and the result of diversified ways. very important present medical questions are even if a biopsy will be taken of choroidal melanomas, what will be performed with this biopsy, and even if high-risk sufferers might be screened usually. This quantity describes the scientific features of uveal cancer besides the several present recommendations to be had for remedy, similar to radioactive plaque remedy, proton beam remedy, and native tumor resection. additionally, thoughts for taking biopsies and characterizing biopsy fabric are established. destiny treatments similar to anti-VEGF therapy and innovations for the remedy of metastases also are mentioned. citizens with an curiosity in ocular oncology, ophthalmologists or physicians facing uveal cancer, in addition to sufferers wishing to understand extra approximately this malignancy will discover a topical replace on uveal cancer during this booklet.
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Additional resources for Current Concepts in Uveal Melanoma (Developments in Ophthalmology)
Surgical resection is difficult if the tumour is thin and is more likely to be complicated by local recurrence if the tumour margins are diffuse. These features are therefore indications for some form of radiotherapy. Proton beam radiotherapy provides a uniform dose of radiation to the tumour and allows modulation of the beam so as to minimise radiation of the cornea and lens. Brachytherapy may be more convenient for patients living far from Liverpool, but requires two surgical procedures and delivers relatively high doses of radiation to the cornea and sclera, thereby increasing the chances of keratopathy and scleral necrosis, particularly with thick tumours.
The dose rate falls significantly near the periphery, 28 Pe’er Fig. 1. 16 types of Ru-106 eye applicators (Source: Eckert & Ziegler BEBIG GmbH). and within about 1 mm of the applicator edge the dose is about 60–70% of the center value. While being manufactured by Isocommerz (Berlin, Germany) using the ASMW specification (ASMW is the standardization office of the former German Democratic Republic), the relative distribution of activity on the plaque surface was measured only on a few points, and the dose measurements were very inaccurate.
3. a A choroidal melanoma in the right eye, close to the macular area. b The melanoma was treated successfully by positioning of the Ru-106 applicator eccentrically, in order to protect the fovea. 5 years after treatment. brachytherapy are compared to I-125 brachytherapy, treating tumors of similar size, a better preservation of visual acuity was observed in the Ru-106 patients [26, 35, 44, 51]. This can be explained by the fact that Ru-106 plaques emit beta rays, which have a more limited range than the I-125 gamma source, and thus provide a significantly lower dose to the lens, macula and optic nerve head .
Current Concepts in Uveal Melanoma (Developments in Ophthalmology) by M.J. Jager, L. Desjardins, T. Kivelä, B.E. Damato, F. Bandello