The aims of proton beam radiotherapy of uveal melanoma are to eradicate any threat of metastatic disease while conserving the eye with as much useful vision as possible.
As with other ionizing radiation, protons damage cells by disrupting DNA so that tumor cells lose their reproductive ability, hence entering senescence or undergoing apoptosis.1 Tissue damage is greatest at the point where the protons stop moving so that there is a ‘Bragg Peak’ of ionization, with relative sparing of healthy tissues both proximal and distal to the tumor target. Furthermore, the beam can be highly collimated, thereby reducing collateral damage to adjacent structures such as the optic nerve and fovea.
The aims of this review are to discuss the Liverpool approach to proton beam radiotherapy.2–4 This is done in the context of the current literature on the subject