Corneal Substructure Dosimetry Predicts Corneal Toxicity in Patients With Uveal Melanoma Treated With Proton Beam Therapy
| Autor: | Angela Fung, Craig Wells, Alison H. Skalet, Ramesh Rengan, Stephen R. Bowen, Todd R. Klesert, Tony Wong, Andrew W. Stacey, Howard J. Lee, Lia M. Halasz, Charles Bloch, Dean Shibata |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Uveal Neoplasms Cancer Research medicine.medical_specialty Time Factors Adolescent medicine.medical_treatment Urology Limbus Corneae Radiation Dosage 030218 nuclear medicine & medical imaging Cornea 03 medical and health sciences symbols.namesake Young Adult 0302 clinical medicine Risk Factors medicine Proton Therapy Dosimetry Humans Radiology Nuclear Medicine and imaging Radiation treatment planning Radiation Injuries Melanoma Fisher's exact test Aged Aged 80 and over Univariate analysis Radiation business.industry Incidence Dose fractionation Middle Aged Radiation therapy medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis Toxicity symbols Female sense organs Dose Fractionation Radiation business Relative Biological Effectiveness Radiotherapy Image-Guided |
| Zdroj: | International journal of radiation oncology, biology, physics. 104(2) |
| ISSN: | 1879-355X |
| Popis: | PURPOSE This study examines the relationship between dose to corneal substructures and incidence of corneal toxicity within 6 months of proton beam therapy (PBT) for uveal melanoma. We aim to develop clinically meaningful dose constraints that can be used to mitigate corneal toxicity. METHODS AND MATERIALS Ninety-two patients were treated with PBT between 2015 and 2017 and evaluated for grade 2+ (GR2+) intervention-requiring corneal toxicity in our prospectively maintained database. Most patients were treated with 50 Gy (relative biological effectiveness [RBE]) in 5 fractions, and all had complete six-month follow-up. Analyses included Mann-Whitney, χ2, Fisher exact, and receiver operating curve tests to identify risk factors for GR2+ toxicity. Bivariate logistic regression was used to identify independent dose-volume histogram (DVH) predictors of toxicity after adjustment for the most important clinical risk factor. RESULTS The 6-month PBT GR2+ corneal toxicity rate was 10.9%, with half of patients experiencing grade 2 toxicity and half experiencing grade 3 toxicity, with no grade 4 events. Patients with anterior chamber tumors had a higher risk (58.3%) for toxicity than those with posterior tumors (0%) or posterior tumors extending past the equator (25%, P |
| Databáze: | OpenAIRE |
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