Side effects of proton beam therapy of choroidal melanoma in dependence of the dose to the optic disc and the irradiated
- PDF / 641,538 Bytes
- 11 Pages / 595.276 x 790.866 pts Page_size
- 43 Downloads / 159 Views
ONCOLOGY
Side effects of proton beam therapy of choroidal melanoma in dependence of the dose to the optic disc and the irradiated length of the optic nerve Aline I. Riechardt 1 & Andrea Stroux 2 & Ira Seibel 1 & Jens Heufelder 1,3 & Oliver Zeitz 1 & Dirk Böhmer 4 & Antonia M. Joussen 1 & Johannes Gollrad 4 Received: 17 October 2019 / Revised: 14 April 2020 / Accepted: 1 June 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To analyze the impact of the dose to the optic disc and the irradiated length of the optic nerve on radiation-induced optic neuropathy, radiation-induced retinopathy, iris neovascularization, secondary glaucoma, enucleation, and local tumor control after proton beam therapy (PBT) of choroidal melanoma. Method Retrospective analysis of 1129 patients, who received primary PBT for the treatment of choroidal melanoma with a dose of 60 cobalt gray equivalents (CGE) between 1998 and 2013 at the Helmholtz-Zentrum Berlin, Germany. Kaplan-Meier curves and logrank test have been used for time-to-event analyses. Adjustment for potential confounders was done using multiple Cox regression models with forward and backward selection. Results We found a significant correlation between the irradiated length of the optic nerve and the dose to the optic disc (correlation coefficient, 0.93). Multivariate Cox regression revealed the dose to the optic disc as an independent predictive risk factor for the development of radiation-induced optic neuropathy (p < 0.001, HR 1.023, 95 CI 1.016–1.029), iris neovascularization (p < 0.001, HR 1.013, 95% CI 1.008–1.019), secondary glaucoma (p < 0.001, HR 1.017, 95% CI: 1.011-1.023) and enucleation (p < 0.001, HR 1.037, 95% CI 1.020-1.053). The irradiated length of the optic nerve was not a statistically independent predictive risk factor in multivariate analysis. Conclusion Our data implicate the predominance of the dose to the optic disc over the irradiated length of the optic nerve regarding radiation-induced optic neuropathy, iris neovascularization, secondary glaucoma, and enucleation. Keywords Choroidal melanoma . Proton beam therapy . Irradiated nerve length . Dose to the optic disc . Secondary glaucoma
Introduction Aline I. Riechardt and Andrea Stroux contributed equally to this work. * Aline I. Riechardt [email protected] 1
Augenklinik/Department of Ophthalmology, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, D-12203 Berlin, Germany
2
Institute for Biometry and Clinical Epidemiology, Charité Universitätsmedizin Berlin, Berlin Institute of Health (BIH), Berlin, Germany
3
BerlinProtonen at the Helmholtz-Zentrum Berlin, Charité Universitätsmedizin Berlin, Berlin, Germany
4
Department of Radiation Oncology, Charité - Universitätsmedizin Berlin, Berlin, Germany
In recent years, several large studies have established the role of proton beam therapy (PBT) in the treatment of uveal melanoma, which combines high local control rates with long-term eye preservation and acceptable toxicit
Data Loading...
