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Title: Dry Eye Syndrome After Proton Therapy of Ocular Melanomas

Abstract

Purpose: To investigate whether proton therapy (PT) performs safely in superotemporal melanomas, in terms of risk of dry-eye syndrome (DES). Methods and Materials: Tumor location, DES grade, and dose to ocular structures were analyzed in patients undergoing PT (2005-2015) with 52 Gy (prescribed dose, not accounting for biologic effectiveness correction of 1.1). Prognostic factors of DES and severe DES (sDES, grades 2-3) were determined with Cox proportional hazard models. Visual acuity deterioration and enucleation rates were compared by sDES and tumor locations. Results: Median follow-up was 44 months (interquartile range, 18-60 months). Of 853 patients (mean age, 64 years), 30.5% had temporal and 11.4% superotemporal tumors. Five-year incidence of DES and sDES was 23.0% (95% confidence interval [CI] 19.0%-27.7%) and 10.9% (95% CI 8.2%-14.4%), respectively. Multivariable analysis showed a higher risk for sDES in superotemporal (hazard ratio [HR] 5.82, 95% CI 2.72-12.45) and temporal tumors (HR 2.63, 95% CI 1.28-5.42), age ≥70 years (HR 1.90, 95% CI 1.09-3.32), distance to optic disk ≥5 mm (HR 2.71, 95% CI 1.52-4.84), ≥35% of retina receiving 12 Gy (HR 2.98, 95% CI 1.54-5.77), and eyelid rim irradiation (HR 2.68, 95% CI 1.49-4.80). The same risk factors were found for DES. Visual acuity deteriorated more in patients with sDES (0.86 ± 1.10 vs 0.64 ± 0.98more » logMAR, P=.034) but not between superotemporal/temporal and other locations (P=.890). Enucleation rates were independent of sDES (P=.707) and tumor locations (P=.729). Conclusions: Severe DES was more frequent in superotemporal/temporal melanomas. Incidence of vision deterioration and enucleation was no higher in patients with superotemporal melanoma than in patients with tumors in other locations. Tumor location should not contraindicate PT.« less

Authors:
 [1]; ;  [2];  [1];  [2];  [1];  [3];  [2]
  1. Proton Therapy Unit, Department of Radiation Therapy, Centre Antoine Lacassagne, Nice (France)
  2. Department of Ophthalmology, Pasteur 2 Hospital, Eye University Clinic, Nice (France)
  3. Department of Biostatistics, Institut de Cancérologie de Lorraine, Vandoeuvre les Nancy (France)
Publication Date:
OSTI Identifier:
22649917
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 98; Journal Issue: 1; Other Information: Copyright (c) 2017 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; EYES; GY RANGE 10-100; MELANOMAS; PATIENTS; PLATINUM; PROTON BEAMS; RADIOTHERAPY

Citation Formats

Thariat, Juliette, E-mail: jthariat@gmail.com, Maschi, Celia, Lanteri, Sara, Peyrichon, Marie Laure, Baillif, Stephanie, Herault, Joel, Salleron, Julia, and Caujolle, Jean Pierre. Dry Eye Syndrome After Proton Therapy of Ocular Melanomas. United States: N. p., 2017. Web. doi:10.1016/J.IJROBP.2017.01.199.
Thariat, Juliette, E-mail: jthariat@gmail.com, Maschi, Celia, Lanteri, Sara, Peyrichon, Marie Laure, Baillif, Stephanie, Herault, Joel, Salleron, Julia, & Caujolle, Jean Pierre. Dry Eye Syndrome After Proton Therapy of Ocular Melanomas. United States. doi:10.1016/J.IJROBP.2017.01.199.
Thariat, Juliette, E-mail: jthariat@gmail.com, Maschi, Celia, Lanteri, Sara, Peyrichon, Marie Laure, Baillif, Stephanie, Herault, Joel, Salleron, Julia, and Caujolle, Jean Pierre. Mon . "Dry Eye Syndrome After Proton Therapy of Ocular Melanomas". United States. doi:10.1016/J.IJROBP.2017.01.199.
@article{osti_22649917,
title = {Dry Eye Syndrome After Proton Therapy of Ocular Melanomas},
author = {Thariat, Juliette, E-mail: jthariat@gmail.com and Maschi, Celia and Lanteri, Sara and Peyrichon, Marie Laure and Baillif, Stephanie and Herault, Joel and Salleron, Julia and Caujolle, Jean Pierre},
abstractNote = {Purpose: To investigate whether proton therapy (PT) performs safely in superotemporal melanomas, in terms of risk of dry-eye syndrome (DES). Methods and Materials: Tumor location, DES grade, and dose to ocular structures were analyzed in patients undergoing PT (2005-2015) with 52 Gy (prescribed dose, not accounting for biologic effectiveness correction of 1.1). Prognostic factors of DES and severe DES (sDES, grades 2-3) were determined with Cox proportional hazard models. Visual acuity deterioration and enucleation rates were compared by sDES and tumor locations. Results: Median follow-up was 44 months (interquartile range, 18-60 months). Of 853 patients (mean age, 64 years), 30.5% had temporal and 11.4% superotemporal tumors. Five-year incidence of DES and sDES was 23.0% (95% confidence interval [CI] 19.0%-27.7%) and 10.9% (95% CI 8.2%-14.4%), respectively. Multivariable analysis showed a higher risk for sDES in superotemporal (hazard ratio [HR] 5.82, 95% CI 2.72-12.45) and temporal tumors (HR 2.63, 95% CI 1.28-5.42), age ≥70 years (HR 1.90, 95% CI 1.09-3.32), distance to optic disk ≥5 mm (HR 2.71, 95% CI 1.52-4.84), ≥35% of retina receiving 12 Gy (HR 2.98, 95% CI 1.54-5.77), and eyelid rim irradiation (HR 2.68, 95% CI 1.49-4.80). The same risk factors were found for DES. Visual acuity deteriorated more in patients with sDES (0.86 ± 1.10 vs 0.64 ± 0.98 logMAR, P=.034) but not between superotemporal/temporal and other locations (P=.890). Enucleation rates were independent of sDES (P=.707) and tumor locations (P=.729). Conclusions: Severe DES was more frequent in superotemporal/temporal melanomas. Incidence of vision deterioration and enucleation was no higher in patients with superotemporal melanoma than in patients with tumors in other locations. Tumor location should not contraindicate PT.},
doi = {10.1016/J.IJROBP.2017.01.199},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 1,
volume = 98,
place = {United States},
year = {Mon May 01 00:00:00 EDT 2017},
month = {Mon May 01 00:00:00 EDT 2017}
}