University of São Paulo: Combined treatment shrinks tumor, prevents eyeball loss and inactivates cancer, study finds


“I was with my husband on the street and I confused the colors of a traffic light. That worried us and two days later, I went to a specialist doctor and there the melanoma was already detected. I was devastated, helpless and very sad”, recalls Maria Santos (not her real name). The nursing technician had a tumor in the choroid, the ocular layer that helps in the nutrition and oxygenation of the retina. Maria’s melanoma was classified as a large tumor. Cases like hers have no indication for brachytherapy, a technique used in the treatment of melanoma that consists of the temporary insertion of an ionizing radiation plate inside the eye and close to the tumor that prevents loss of the eyeball (eye enucleation) and metastasis. .

To treat these large melanomas that affect the choroid, researchers from the Faculty of Medicine of Ribeirão Preto (FMRP) at USP developed studies to improve existing methods. Maria underwent the application of a combined treatment of intra-arterial chemotherapy, with melphalan chemotherapy, and brachytherapy. The results “show a tumor regression from 10.4 millimeters to 7.9 millimeters with intra-arterial infusion, making Maria suitable for brachytherapy”, commemorates the ophthalmologist Rodrigo Jorge, professor at FMRP.

Rodrigo Jorge, ophthalmologist and professor at FMRP
The intra-arterial chemotherapy technique with melphalan chemotherapy is already used in cases of liver and skin metastases, but it had not yet been used in the treatment of primary tumors. “I started studying and saw that other studies have already addressed the same treatment for skin melanoma with drug circulation in the femoral (leg), for example. Another study indicated that choroidal melanoma sent ‘seeds’ to the liver and that the treatment was the same”, says the professor.

After undergoing intra-arterial chemotherapy, the researchers performed brachytherapy, which caused the cancer to regress to 4.9 millimeters, becoming inactive. “In addition, we managed to ensure that she maintained around 10% to 20% of her vision and aesthetically, no one noticed anything in the eye, this is important for the patient’s quality of life”, says Jorge.

For Maria, the moment was one of great confidence in the good results of the combined treatment. “The medical team and the desire to get well made me renew hope in the result of the cure. I am fine, the treatment was effective, as in addition to reducing the tumor by half, it left it inactive,” she points out.

The next steps involve applying the combined treatment to patients already recruited by the group of researchers and validating the previous results obtained with Maria. “We still cannot insert the procedure in health care, as it is necessary to carry out new scientific studies to confirm the data already obtained”, he concludes.

The results of the work are in the article Melphalan intra-arterial chemotherapy for choroidal melanoma chemoreduction , published by the International Journal of Retina and Vitreous , authored by Professor Rodrigo Jorge and researchers Igor Coelho, Gustavo Viani, Amanda Alexia R. Vieira, Fernando Chahud, Daniel G. Abud and Zelia M. Correa.

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