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.

Purpose: This study aimed to compare QoL outcomes among patients undergoing active breathing control (ABC), voluntary deep inspiration breath hold (vDIBH), and surface-guided radiation therapy (SGRT). Methods: This was a non-randomized, three-arm clinical trial in which 55 patients were sequentially allocated to ABC (n = 19), SGRT (n = 20), or vDIBH (n = 16). QoL was assessed using the European Organization for Research and Treatment of Cancer QoL questionnaire (EORTC QLQ-C30) at baseline, treatment completion, and 6–8 weeks post-treatment. Linear regression was used to compare changed scales in QoL domains across groups. A p-value of <0.05 was considered statistically significant. Results: Baseline QoL scores were high across all groups, with physical functioning being the highest-rated domain and global health status the lowest. Fatigue, pain, and insomnia were the most highly reported symptoms at all time points. At 6–8 weeks, social functioning improved significantly in SGRT compared to vDIBH (16.67 vs. −12.50, p = 0.0053). Patients in the vDIBH group reported significantly increased pain compared to ABC at 6–8 weeks (p = 0.0240). No other significant differences were observed in QoL changes between the groups. Conclusions: The three breath-hold techniques maintained overall QoL with no differences between the groups, except for pain between vDIBH and ABC and social functioning for vDIBH and SGRT both at 6–8 weeks of follow-up. Despite the limitations of this study, each breath-hold technique has demonstrated comparable impact on QoL in patients with left-sided breast cancer and each could be used as a viable option with respect to QoL.

Purpose of review: Persistent chemotherapy-induced alopecia (pCIA) is defined as incomplete hair growth ≥6 months after chemotherapy completion. This scoping review aimed to identify gaps for future research by mapping pCIA’s incidence, risk factors, quality-of-life (QoL) impacts, presentation, prevention, and management. Recent findings: Thirty-nine articles were included. The most common study type was case reports (12/39, 30.8%). Only 2/39 (5.1%) were randomized controlled trials (RCTs). Most studies (27/39, 69.2%) reported pCIA in patients with breast cancer. Alkylating agents, taxanes, and anthracyclines were most frequently reported to be associated with pCIA. All six studies that evaluated QoL reported that pCIA negatively affected patients’ psychological, functional, and social well-being. Scalp cooling was the only intervention shown to prevent pCIA in four studies. Twenty-one studies reported on interventions for the management of pCIA. Topical minoxidil was reported to improve pCIA in 7 out of 12 studies (58.3%). Low-dose oral minoxidil demonstrated benefit in 7 out of 7 studies (100%). Summary: pCIA’s incidence and risk factors should be prospectively evaluated across cancer types and chemotherapeutic agents. Given pCIA’s significant QoL impacts, RCTs should be conducted to investigate existing and emerging interventions for its prevention and management, and to consider including these interventions in the standard of care.