Download Current Concepts in Uveal Melanoma (Developments in by M.J. Jager, L. Desjardins, T. Kivelä, B.E. Damato, F. PDF

By M.J. Jager, L. Desjardins, T. Kivelä, B.E. Damato, F. Bandello

Uveal cancer is an competitive type of melanoma that may contain the iris, the ciliary physique, and/or the choroid, that is the most place of this tumor. sufferers frequently desire to be told approximately therapy offerings and the result of assorted techniques. very important present medical questions are no matter if a biopsy can be taken of choroidal melanomas, what could be performed with this biopsy, and no matter if high-risk sufferers may be screened frequently. This quantity describes the medical features of uveal cancer besides the various present innovations on hand for remedy, reminiscent of radioactive plaque remedy, proton beam treatment, and native tumor resection. moreover, strategies for taking biopsies and characterizing biopsy fabric are validated. destiny remedies akin to anti-VEGF remedy and concepts for the therapy 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 e-book.

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There is also much variation in the way that the different treatments are undertaken. As for quality of life studies, these have tended to merge all patients into one cohort whereas it is likely that different age groups and sexes will each respond in a particular manner. Furthermore, quality of life is determined not only by the type of treatment that is administered but also whether or not such treatment is successful in conserving vision and preventing local recurrence. To my knowledge, patient-centred outcomes have not been reported according to these factors.

4% after 5 years [43] to as high as 17–18% [30, 47], similar to the results of the COMS group [48]. 32 Pe’er a b Fig. 2. 3 mm in maximal height. 2 mm and after a follow-up of 5 years. Visual Outcome Conservative treatment of uveal melanoma is aimed not only at preserving the eye globe but also, whenever possible, at preserving vision. The loss of visual acuity following brachytherapy depends on several risk factors; the most important ones are reduced initial visual acuity before treatment, and the distance between the posterior tumor margins and the vital ocular structures – the fovea and the optic nerve head [30, 35].

Technique of Proton Beam Therapy for Uveal Melanoma The principle of proton beam therapy derives from the physical properties of accelerated proton (the Bragg peak) [12]. The accelerated proton delivers all its energy at a precise point and there is very little radiation around and behind this point. It is then possible to deliver a high dose of radiation to the tumor while sparing the normal 42 Desjardins et al. Fig. 2. Scleral transillumination. tissue. Nevertheless it is important to keep in mind that the radiation dose at the entrance of the beam is quite high, especially for large tumors (irradiation of the lacrimal gland for tumors located at the superotemporal quadrant can induce the sicca syndrome).

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