Clinical Spectrum and Outcomes of Ocular and Periocular Complications following External-Beam Radiotherapy for Inoperable Malignant Maxillary Sinus Tumors
Clinical Spectrum and Outcomes of Ocular and Periocular Complications following External-Beam Radiotherapy for Inoperable Malignant Maxillary Sinus Tumors
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无法手术的恶性上颌窦肿瘤进行外照射放射治疗后眼部和眼周并发症的临床谱和结果
DOI：
10.1159/000511011
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发表时间：
2020
影响因子：
1
通讯作者：
T. Patel
中科院分区：
文献类型：
--
作者：
D. Ting;Romeela Rana;J. Ng;D. Wilkinson;Desiree Ah;T. Patel
目的：探讨大剂量外照射(EBRT)治疗不能手术的恶性上颌窦肿瘤(MMST)后眼/眼周围并发症的临床特点、处理方法及预后。方法：采用回顾性介入性病例系列研究。所有在英国詹姆斯库克大学医院被诊断为不能手术的MMST(伴有眼眶受累)并接受大剂量分割EBRT(65Gy30次)的患者都包括在内。结果：共纳入7例晚期MMST患者(T4aN0M0-T4bN2cM0)，随访时间为23.8±10.2个月。严重的眼睑边缘疾病、干眼症和神经营养性角膜病变被普遍观察到。其他并发症包括瘢痕性结膜炎(71%)、角膜穿孔(57%)、角膜缘干细胞缺乏症(43%)、青光眼(29%)和念珠菌性角膜炎(14%)。羊膜移植(71%)、眼睑修补(43%)、构造性角膜移植(29%)和脏器摘除(14%)是必要的。所有患者均观察到完整的角膜上皮细胞，3例(43%)患者矫正远视力良好(≥20/60)。结论：大剂量EBRT治疗不能手术的MMST可导致一系列严重的眼/眼周并发症。羊膜移植为恢复严重放射性角膜病变后眼表完整性提供了一种潜在的有用的治疗方法。我们主张积极监测EBRT期间和术后的任何眼部并发症，以便及时干预。
Purpose: To highlight the clinical spectrum, management, and outcomes of ocular/periocular complications following high-dose external-beam radiotherapy (EBRT) for inoperable malignant maxillary sinus-involving tumors (MMST). Methods: A retrospective, interventional case series. All patients who were diagnosed with inoperable MMST (with orbital involvement) and treated with high-dose fractionated EBRT (65 Gy in 30 fractions) at James Cook University Hospital, UK, were included. Results: Seven patients with advanced MMST (T4aN0M0–T4bN2cM0) were included and were followed up for 23.8 ± 10.2 months. Severe lid margin disease, dry eye, and neurotrophic keratopathy were universally observed. Other complications included cicatricial conjunctivitis (71%), corneal perforation (57%), limbal stem cell deficiency (LSCD; 43%), glaucoma (29%), and superimposed candida keratitis (14%). Amniotic membrane transplant (AMT; 71%), tarsorrhaphy (43%), tectonic keratoplasty (29%), and evisceration (14%) were warranted. Intact corneal epithelium was observed in all patients and good corrected-distance visual acuity (≥20/60) was observed in 3 (43%) patients at final follow-up. Conclusion: High-dose EBRT for inoperable MMST can lead to a wide array of severe ocular/periocular complications. AMT serves as a potentially useful treatment modality to restore the ocular surface integrity after severe radiation keratopathy. We advocate active monitoring for any evolving ophthalmic complications during and after EBRT to enable timely intervention.
DOI：
10.1016/j.ijrobp.2009.07.1754
发表时间：
2010-03-01
影响因子：
7
作者：
Marks, Lawrence B.;Yorke, Ellen D.;Jackson, Andrew;Ten Haken, Randall K.;Constine, Louis S.;Eisbruch, Avraham;Bentzen, Soren M.;Nam, Jiho;Deasy, Joseph O.
通讯作者：
Deasy, Joseph O.