{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T05:18:13Z","timestamp":1783055893104,"version":"3.54.6"},"reference-count":34,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Ophthalmologica"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Uveal melanoma (UM) is a rare cancer with rising number of diagnosis (143 diagnoses in 1990 to 226 in 2023) in the Netherlands. Most patients are treated locally with Ruthenium\u2010106 brachytherapy (\u00b1102\/year). Patients were referred for proton therapy (PT) to Switzerland in the past, but PT is available in the Netherlands from January 2020 onwards. The purpose of this study is to assess the oncological and ophthalmological outcomes of the current cohort and compare with the published historic cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>\n                      All consecutive patients with PT for UM from January 2020 till 31st December 2023 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009176) and the Historic Cohort (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009101) were treated with 4\u2009\u00d7\u200915 Cobalt Gray Equivalent and were included. Time to event analyses were conducted according to the Kaplan\u2013Meier method.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median age in the current cohort was 65\u2009years (Historic: 59,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). Tumour stage differed between the cohorts T1 current 10% (historic 3%), T2 21% (26%), T3 55% (36%), T4 14% (36%) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004). Tumours regressed in 2\u20133\u2009years to a remnant of around 3\u2009mm. At 3\u2009years, OS was 78.9% (86%), DM 26.6% (17%), LF 3.5% (6%) and enucleation rate 16.8% (19%), the latter mostly because of pain and\/or retinal detachment. In both cohorts, visual acuity dropped substantially after treatment (median \u22120.50). At 3\u2009years, in both cohorts, around a quarter of the patients retained a vision of \u22650.3. Retinal detachment was the most common toxicity in the current cohort with 52.3%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The establishment of the HollandPTC improves access to PT for Dutch UM patients and results in additional sparing of around 40 eyes per year. Tumour regression after treatment happened gradually from 3\u2009months to 2\u20133\u2009years, often leaving a rest behind of 3\u20135\u2009mm. Tumour control, eye preservation rates, and side effects are similar to the published historic cohort treated abroad.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aos.70195","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T04:35:43Z","timestamp":1783053343000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Three years of ocular proton therapy in the Netherlands, clinical results"],"prefix":"10.1111","author":[{"given":"C.","family":"Rasch","sequence":"first","affiliation":[{"name":"Holland Particle Therapy Center  Delft the Netherlands"},{"name":"Department of Radiation Oncology Leiden University Medical Center  Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Marinkovic","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Leiden University Medical Center  Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Pors","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Leiden University Medical Center  Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Kilic","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology ErasmusMC  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Naus","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology ErasmusMC  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Yavuzyigitoglu","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology ErasmusMC  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. A.","family":"Bakker","sequence":"additional","affiliation":[{"name":"Holland Particle Therapy Center  Delft the Netherlands"},{"name":"Department of Radiation Oncology Leiden University Medical Center  Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"van Rij","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology ErasmusMC  Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. W.","family":"Beenakker","sequence":"additional","affiliation":[{"name":"Holland Particle Therapy Center  Delft the Netherlands"},{"name":"Department of Radiation Oncology Leiden University Medical Center  Leiden the Netherlands"},{"name":"Department of Ophthalmology Leiden University Medical Center  Leiden the Netherlands"},{"name":"Department of Radiology Leiden University Medical Center  Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Bleeker","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Leiden University Medical Center  Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Schalenbourg","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Jules\u2010Gonin Eye Hospital, FAA, University of Lausanne  Lausanne Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Pica","sequence":"additional","affiliation":[{"name":"Center for Proton Therapy Paul Scherrer Institute  Villigen Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Hrbacek","sequence":"additional","affiliation":[{"name":"Center for Proton Therapy Paul Scherrer Institute  Villigen Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Horeweg","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Leiden University Medical Center  Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Vu","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Leiden University Medical Center  Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,2]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"49","article-title":"Proton beam radiotherapy in the management of uveal melanoma: clinical experience in Scotland","volume":"3","author":"Aziz S.","year":"2009","journal-title":"Clinical Ophthalmology"},{"key":"e_1_2_6_3_1","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.ajo.2016.02.027","article-title":"Outcomes after proton beam therapy for large choroidal melanomas in 492 patients","volume":"165","author":"Bensoussan E.","year":"2016","journal-title":"American Journal of Ophthalmology"},{"key":"e_1_2_6_4_1","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/S0360-3016(99)00147-9","article-title":"Results of proton therapy of uveal melanomas treated in Nice","volume":"45","author":"Courdi A.","year":"1999","journal-title":"International Journal of Radiation Oncology, Biology, Physics"},{"key":"e_1_2_6_5_1","doi-asserted-by":"crossref","first-page":"1405","DOI":"10.1016\/j.ijrobp.2005.01.016","article-title":"Proton beam radiotherapy of choroidal melanoma: the Liverpool\u2010Clatterbridge experience","volume":"62","author":"Damato B.","year":"2005","journal-title":"International Journal of Radiation Oncology, Biology, Physics"},{"key":"e_1_2_6_6_1","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/j.sjopt.2013.06.014","article-title":"Proton beam radiotherapy of uveal melanoma","volume":"27","author":"Damato B.","year":"2013","journal-title":"Saudi Journal of Ophthalmology"},{"key":"e_1_2_6_7_1","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1016\/S0360-3016(02)04200-1","article-title":"Eye retention after proton beam radiotherapy for uveal melanoma","volume":"55","author":"Egger E.","year":"2003","journal-title":"International Journal of Radiation Oncology, Biology, Physics"},{"key":"e_1_2_6_8_1","doi-asserted-by":"crossref","first-page":"1315","DOI":"10.1002\/mp.14665","article-title":"Three\u2010dimensional MRI\u2010based treatment planning approach for non\u2010invasive ocular proton therapy","volume":"48","author":"Fleury E.","year":"2021","journal-title":"Medical Physics"},{"key":"e_1_2_6_9_1","doi-asserted-by":"crossref","first-page":"4506","DOI":"10.1002\/mp.15024","article-title":"Characterization of the HollandPTC proton therapy beamline dedicated to uveal melanoma treatment and an interinstitutional comparison","volume":"48","author":"Fleury E.","year":"2021","journal-title":"Medical Physics"},{"key":"e_1_2_6_10_1","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1016\/S0360-3016(00)01430-9","article-title":"Proton radiation therapy for medium and large choroidal melanoma: preservation of the eye and its functionality","volume":"49","author":"Fuss M.","year":"2001","journal-title":"International Journal of Radiation Oncology, Biology, Physics"},{"key":"e_1_2_6_11_1","doi-asserted-by":"crossref","first-page":"4666","DOI":"10.1167\/iovs.06-0659","article-title":"Proton beam irradiation of uveal melanomas: the first 30\u2009years. 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