PMID- 28586953
OWN - NLM
STAT- MEDLINE
DCOM- 20170721
LR  - 20180215
IS  - 1879-355X (Electronic)
IS  - 0360-3016 (Linking)
VI  - 98
IP  - 1
DP  - 2017 May 1
TI  - Dry Eye Syndrome After Proton Therapy of Ocular Melanomas.
PG  - 142-151
LID - S0360-3016(17)30235-3 [pii]
LID - 10.1016/j.ijrobp.2017.01.199 [doi]
AB  - 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.
CI  - Copyright (c) 2017 Elsevier Inc. All rights reserved.
FAU - Thariat, Juliette
AU  - Thariat J
AD  - Proton Therapy Unit, Department of Radiation Therapy, Centre Antoine Lacassagne, 
      Nice, France. Electronic address: jthariat@gmail.com.
FAU - Maschi, Celia
AU  - Maschi C
AD  - Department of Ophthalmology, Pasteur 2 Hospital, Eye University Clinic, Nice, 
      France.
FAU - Lanteri, Sara
AU  - Lanteri S
AD  - Department of Ophthalmology, Pasteur 2 Hospital, Eye University Clinic, Nice, 
      France.
FAU - Peyrichon, Marie Laure
AU  - Peyrichon ML
AD  - Proton Therapy Unit, Department of Radiation Therapy, Centre Antoine Lacassagne, 
      Nice, France.
FAU - Baillif, Stephanie
AU  - Baillif S
AD  - Department of Ophthalmology, Pasteur 2 Hospital, Eye University Clinic, Nice, 
      France.
FAU - Herault, Joel
AU  - Herault J
AD  - Proton Therapy Unit, Department of Radiation Therapy, Centre Antoine Lacassagne, 
      Nice, France.
FAU - Salleron, Julia
AU  - Salleron J
AD  - Department of Biostatistics, Institut de Cancerologie de Lorraine, Vandoeuvre les 
      Nancy, France.
FAU - Caujolle, Jean Pierre
AU  - Caujolle JP
AD  - Department of Ophthalmology, Pasteur 2 Hospital, Eye University Clinic, Nice, 
      France.
LA  - eng
PT  - Journal Article
DEP - 20170129
PL  - United States
TA  - Int J Radiat Oncol Biol Phys
JT  - International journal of radiation oncology, biology, physics
JID - 7603616
SB  - IM
MH  - Age Factors
MH  - Contraindications
MH  - Dry Eye Syndromes/epidemiology/*etiology
MH  - Eye Enucleation/statistics & numerical data
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Incidence
MH  - Lacrimal Apparatus/radiation effects
MH  - Male
MH  - Melanoma/*pathology/*radiotherapy
MH  - Middle Aged
MH  - Prognosis
MH  - Proportional Hazards Models
MH  - Proton Therapy/*adverse effects/methods
MH  - Radiotherapy Dosage
MH  - Time Factors
MH  - Uveal Neoplasms/*pathology/*radiotherapy
MH  - Visual Acuity/radiation effects
EDAT- 2017/06/08 06:00
MHDA- 2017/07/22 06:00
CRDT- 2017/06/08 06:00
PHST- 2016/06/23 00:00 [received]
PHST- 2016/12/27 00:00 [revised]
PHST- 2017/01/09 00:00 [accepted]
PHST- 2017/06/08 06:00 [entrez]
PHST- 2017/06/08 06:00 [pubmed]
PHST- 2017/07/22 06:00 [medline]
AID - S0360-3016(17)30235-3 [pii]
AID - 10.1016/j.ijrobp.2017.01.199 [doi]
PST - ppublish
SO  - Int J Radiat Oncol Biol Phys. 2017 May 1;98(1):142-151. doi: 
      10.1016/j.ijrobp.2017.01.199. Epub 2017 Jan 29.