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

the patient to be treated quickly and, if necessary, dynamic phototherapy, laser or anti-angiogenic
reduce the time before resumption of any systemic instillations are possible but external radiotherapy
treatment. The results of exclusive photon radiation remains the oldest and proven technique in clinical
therapy of the main cohorts published in the literature routine. [27,28]
are reported in Table 3. According to the series, the
[21]
rates of stabilization or improvement of symptoms In addition, systemic treatment alone with conventional
vary from 57% to 100%. The results of our study are chemotherapy or targeted therapy may have a local
[29]
comparable. anti-tumor action on choroidal metastases. The
optimal therapeutic attitude could be the sequential
Other therapeutic alternatives to conventional photon association of choroidal radiotherapy and systemic
radiation therapy have been reported. Some teams treatment. [30,31]
have used stereotactic radiotherapy or proton therapy
on series of patients with very limited numbers. [22,23] In conclusion, radiotherapy is an effective treatment
The results functional results obtained do not appear and low toxicity for the management of choroidal
to be superior in terms of local control of the disease metastases. The hypofractionated regimens should
compared to photonic radiotherapy for classical tumor be preferred in order to reduce the delay before the
sites (breast, lung). These techniques should be resumption of a possible systemic treatment which
reserved for the most radioresistant tumors including could also have a locoregional action on the choroidal
melanomas. [24-26] metastases. This treatment fits perfectly into the
palliative or curative management of oligo- or poly-
Other local treatments such as plate brachytherapy, metastatic disease.
Table 3: Results of external beam radiotherapy with photons
Visual stabilisation or
Authors Effective Primitif tumor (effective) Doses (spliting)
improvement
Burmeister et al. [23] 6 Breast (6) 21 to 27 Gy (3 to 3.4 Gy) 100%
Ratanatharathorn et al. [12] 19 Breast (19) 26 to 46 Gy (1.61 to 3 Gy) 100%
Breast (14)
Nylén et al. [24] 17 Lung (1) 20 to 45 Gy (2 to 4 Gy) 81%
Others (2)
Lung (100)
Röttinger et al. [11] 188 Breast (44) 30 to 40 Gy (2 to 3 Gy) 57%
Others (44)
Breast (38)
Rosset et al. [21] 58 Lung (10) 20 to 53 Gy (1.8 to 2 Gy) 81%
Others (10)
Breast (31)
Wiegel et al. [20] 50 Lung (13) 40 Gy (2 Gy) 86%
Others (6)
Breast (88)
d’Abbadie et al. [16] 123 Lung (11) 18 to 30 Gy (3 to 6 Gy) 68%
Others (24)
Demirci et al. [15] 129 Breast (129) 20 to 64 Gy (1.5 to 3 Gy) 82%
Breast (11)
Bajcsay et al. [25] 17 Lung (4) 42 to 51 Gy (np) 100%
Others (2)
Lung (3) 30 Gy (3 Gy) or 20 Gy
Bellmann et al. [13] 10 Breast (3) 100%
Others (4) SBRT (20 Gy)
Amichetti et al. [14] 49 Breast (49) 16 to 60 Gy (1.8 to 3 Gy) 88%
Kreusel et al. [10] 18 Lung (18) Unspecified 83%
Breast (41)
Konstantinidis et al. [22] 96 Lung (27) Unspecified 94.30%
Others (28)
Journal of Cancer Metastasis and Treatment ¦ Volume 3 ¦ June 30, 2017 109