{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T03:39:41Z","timestamp":1790912381801,"version":"4.1.0"},"reference-count":62,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2024,10,16]],"date-time":"2024-10-16T00:00:00Z","timestamp":1729036800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Varian Medical System","award":["P30 CA008748"],"award-info":[{"award-number":["P30 CA008748"]}]},{"name":"NIH\/NCI Cancer Center Support","award":["P30 CA008748"],"award-info":[{"award-number":["P30 CA008748"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives: Uveal melanoma is the most common primary intraocular malignancy in adults. Treatment options for localized, early-stage disease include enucleation, brachytherapy, and proton beam therapy. This review aims to evaluate the role of proton therapy in the definitive management of uveal melanoma, focusing on its physics, radiobiology, treatment techniques, and associated outcomes. Methods: This narrative review synthesizes current literature on proton therapy for uveal melanoma, emphasizing case selection, treatment efficacy, and side effects. Results: Proton therapy offers significant advantages for thicker uveal melanomas (over 8 mm) due to its unique physical properties, including a rapid dose fall-off that protects critical structures like the retina and optic nerve. Proton therapy may have benefits in tumor control for ocular melanomas given its increased relative biological effectiveness relative to photon therapy for these typically more radioresistant melanomas. Proton therapy may also hold special value for uveal melanomas in close proximity to the optic nerve, as patients are at high risk of visual toxicities with brachytherapy. The review discusses the efficacy of proton therapy across small, medium, and large tumors, along with strategies for improving patient survival through combined systemic therapy. Additionally, the potential of ocular reirradiation with proton therapy is addressed. Conclusions: Proton therapy is an effective treatment for uveal melanoma. It offers advantages over brachytherapy for large tumors, tumors that are close to the optic nerve or insertion of extra-ocular muscles.<\/jats:p>","DOI":"10.3390\/cancers16203497","type":"journal-article","created":{"date-parts":[[2024,10,16]],"date-time":"2024-10-16T07:58:32Z","timestamp":1729065512000},"page":"3497","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Proton Therapy in Uveal Melanoma"],"prefix":"10.3390","volume":"16","author":[{"given":"Adrian Wai","family":"Chan","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Sunnybrook Health Sciences Centre, The University of Toronto, Toronto, ON M4N 3M5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haibo","family":"Lin","sequence":"additional","affiliation":[{"name":"New York Proton Center, New York, NY 10035, USA"},{"name":"Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irini","family":"Yacoub","sequence":"additional","affiliation":[{"name":"New York Proton Center, New York, NY 10035, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arpit M.","family":"Chhabra","sequence":"additional","affiliation":[{"name":"New York Proton Center, New York, NY 10035, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Isabelle","family":"Choi","sequence":"additional","affiliation":[{"name":"New York Proton Center, New York, NY 10035, USA"},{"name":"Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0867-3694","authenticated-orcid":false,"suffix":"2nd","given":"Charles B.","family":"Simone","sequence":"additional","affiliation":[{"name":"New York Proton Center, New York, NY 10035, USA"},{"name":"Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"279","DOI":"10.2147\/OPTH.S89591","article-title":"Uveal Melanoma: Epidemiology, Etiology, and Treatment of Primary Disease","volume":"11","author":"Krantz","year":"2017","journal-title":"Clin. 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