TY - JOUR

T1 - Вторичная энуклеация после протонной терапии увеальной меланомы: клинико-морфологические параллели

AU - Panova, I.E.

AU - Svistunova, E.M.

AU - Vorobyev, S.L.

AU - Vorobyov, N.A.

AU - Samkovich, E.V.

AU - Kalashnikova, E.S.

AU - Martynova, N.I.

AU - Shatskikh, A.V.

AU - Al-Mousa, I.A.

N1 - Export Date: 23 March 2026; Cited By: 0; Correspondence Address: E.M. Svistunova; S. Fyodorov Eye Microsurgery Federal State Institution, Saint Petersburg Branch, Saint Petersburg, Russian Federation; email: em.svistunova@yandex.ru

PY - 2025

Y1 - 2025

N2 - Purpose. To investigate clinical, instrumental, and pathomorphological correlations in patients who underwent secondary enucleation for uveal melanoma (UM) treated with proton beam therapy using pencil beam scanning technology. Material and methods. This study included 7 patients (7 eyes) who underwent secondary enucleation due to treatment- resistant complications that developed 12 to 28 months after proton therapy (median [Me] 18.0 months; interquartile range (IQR) 10.0). The initial tumor prominence ranged from 8.1 to 14.0 mm (Me 11.3 mm; IQR 2.4), basal diameter from 9.5 to 24.4 mm (Me 16.5 mm; IQR 4.3), and tumor volume from 1.6 to 2.7 cm³ (Me 1.9 cm³; IQR 0.5). The protocol included assessment of histological type, tumor size, Bruch’s membrane rupture, mitotic count per mm², and vascular characteristics based on PAS staining and CD34 immunohistochemistry, among other parameters. Results. Secondary enucleation was performed in 16.3% of patients, with follow-up ranging from 1 to 54 months. Patients who underwent enucleation due to neurotrophic keratitis with imminent corneal perforation were characterized by better best-corrected visual acuity (BCVA, Ме 0.8; IQR 0.3), smaller cumulative visual field loss across 8 meridians (Ме 160.0°; IQR 135.0°), higher radiation doses to anterior ocular structures, and lower doses to posterior segments compared to patients with neovascular glaucoma. Spearman correlation analysis showed that greater pre-treatment tumor height was significantly associated with increased maximum vascular diameter (r=0.829, p=0.021); post-treatment tumor height correlated with both tumor area (mm²) (r=0.867, p=0.011) and mitotic activity (r=0.788, p=0.035). Conclusion. The identified clinical, instrumental, and pathomorphological correlations in patients undergoing secondary enucleation should be considered during treatment planning for proton therapy in UM. © Панова И.Е., Свистунова Е.М., Воробьев С.Л., Воробьев Н.А., Самкович Е.В., Калашникова Е.С., Мартынова Н.И., Шацких А.В., Аль-Муса И.А., 2025

AB - Purpose. To investigate clinical, instrumental, and pathomorphological correlations in patients who underwent secondary enucleation for uveal melanoma (UM) treated with proton beam therapy using pencil beam scanning technology. Material and methods. This study included 7 patients (7 eyes) who underwent secondary enucleation due to treatment- resistant complications that developed 12 to 28 months after proton therapy (median [Me] 18.0 months; interquartile range (IQR) 10.0). The initial tumor prominence ranged from 8.1 to 14.0 mm (Me 11.3 mm; IQR 2.4), basal diameter from 9.5 to 24.4 mm (Me 16.5 mm; IQR 4.3), and tumor volume from 1.6 to 2.7 cm³ (Me 1.9 cm³; IQR 0.5). The protocol included assessment of histological type, tumor size, Bruch’s membrane rupture, mitotic count per mm², and vascular characteristics based on PAS staining and CD34 immunohistochemistry, among other parameters. Results. Secondary enucleation was performed in 16.3% of patients, with follow-up ranging from 1 to 54 months. Patients who underwent enucleation due to neurotrophic keratitis with imminent corneal perforation were characterized by better best-corrected visual acuity (BCVA, Ме 0.8; IQR 0.3), smaller cumulative visual field loss across 8 meridians (Ме 160.0°; IQR 135.0°), higher radiation doses to anterior ocular structures, and lower doses to posterior segments compared to patients with neovascular glaucoma. Spearman correlation analysis showed that greater pre-treatment tumor height was significantly associated with increased maximum vascular diameter (r=0.829, p=0.021); post-treatment tumor height correlated with both tumor area (mm²) (r=0.867, p=0.011) and mitotic activity (r=0.788, p=0.035). Conclusion. The identified clinical, instrumental, and pathomorphological correlations in patients undergoing secondary enucleation should be considered during treatment planning for proton therapy in UM. © Панова И.Е., Свистунова Е.М., Воробьев С.Л., Воробьев Н.А., Самкович Е.В., Калашникова Е.С., Мартынова Н.И., Шацких А.В., Аль-Муса И.А., 2025

KW - pencil beam scanning

KW - proton therapy

KW - radiation therapy

KW - secondary enucleation

KW - uveal melanoma

U2 - 10.25276/0235-4160-2025-2S-115-124

DO - 10.25276/0235-4160-2025-2S-115-124

M3 - статья

SP - 115

EP - 124

JO - Fyodorov Journal of Ophthalmic Surgery

JF - Fyodorov Journal of Ophthalmic Surgery

SN - 0235-4160

IS - 2s

ER -