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Youbi et al. Management of choroidal metastasis using external beam radiotherapy

lateral). In our series, some patients benefited from an keratitis, dry eye syndrome, radiation-induced
intensity modulation radiation therapy in arctherapy retinopathy depending on the technique, dose and
or static [Figures 1-3]. The contralateral choroidal especially the clinical context including the patient’s
sparing is controversial. It should be noted that the life expectancy. In the German prospective trial of
[19]
rate of recurrence in the untreated contralateral Wiegel et al., [20] The authors delivered a dose of
choroid is estimated to be low (less than 10%). 40 Gy in 20 fractions of 2 Gy and noted improvement
[15]
However, some authors have reported a rate between or stabilization of symptoms in 86% of cases (an
15% and 20% [16,17] whereas it was zero in the German improvement in 50% and stabilization in 36% of
prospective trial ARO 95-08. cases). The best functional results were obtained for
patients with breast cancer probably due to the use
Potential acute side effects include radiodermatitis, of chemotherapy after irradiation. Rosset et al.
[21]
focal alopecia, conjunctivitis, xerophthalmia, the suggest a normofractionnated dose of at least 35 Gy.
severity of which is doseand field-dependent. However, in practice, hypofractionnated regimens are
[18]
Potential late side effects include cataract, glaucoma, preferred in routine clinical practice. In fact, they allow

Figure 2: Conformal radiotherapy using two beams of 6 MV photons

Figure 3: Volumetric modulated arctherapy using 6 MV photons
108 Journal of Cancer Metastasis and Treatment ¦ Volume 3 ¦ June 30, 2017