Abstract
Background
Uveal melanoma (UM) is the most common primary ocular tumour in adults. The most used eye-preserving treatments are charged-particle therapy (CPT) and brachytherapy. We performed a systematic review and meta-analysis to compare efficacies and complications of these two radiotherapies.
Methods
We searched EMBASE, PubMed, MEDLINE, and the Cochrane Library from January 2012 to December 2022. Two independent reviewers identified controlled studies comparing outcomes of CPT versus brachytherapy. Case series that utilize either treatment modality were also reviewed.
Results
One hundred fifty studies met the eligibility criteria, including 2 randomized control trials, 5 controlled cohort studies, and 143 case series studies. We found significant reduction in local recurrence rate among patients treated with CPT compared to brachytherapy (Odds ratio[OR] 0.38, 95% Confidence interval [CI] 0.24ā0.60, pā<ā0.01). Analysis also showed a trend of increased risks of secondary glaucoma after CPT. No statistically significant differences were found in analyzing risks of mortality, enucleation, and cataract.
Conclusions
Our study suggested no difference in mortality, enucleation rate and cataract formation rate comparing the two treatments. Lower local recurrence rate and possibly higher secondary glaucoma incidence was noted among patients treated with CPT. Nevertheless, the overall level of evidence is limited, and further high-quality studies are necessary to provide a more definitive conclusion.
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Data availability
This study is registered was registered with PROSPERO (ID:399075.) Extracted data are available online(link); additional requests may be made to the corresponding author.
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YHT, CAH and YBC were responsible for designing the review protocol, screening potentially eligible studies, and interpreting results. YHT and CAH were responsible for conducting the search, extracting and analyzing the data, updating reference lists and drafting the original article. YBC supervised and provided feedback on the report. All authors have read and agreed to the published version of the manuscript.
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Tseng, YH., Hsu, CA. & Chou, YB. Comparing efficacy of charged-particle therapy with brachytherapy in treatment of uveal melanoma. Eye (2024). https://doi.org/10.1038/s41433-024-03035-y
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DOI: https://doi.org/10.1038/s41433-024-03035-y
