Outcomes of visual acuity in carbon ion radiotherapy: Analysis of dose-volume histograms and prognostic factors
Outcomes of visual acuity in carbon ion radiotherapy: Analysis of dose-volume histograms and prognostic factors
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DOI：
10.1016/j.ijrobp.2005.07.298
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发表时间：
2006-02-01
影响因子：
7
通讯作者：
Tsujii, H
中科院分区：
文献类型：
--
作者：
Hasegawa, A;Mizoe, JE;Tsujii, H
目的：分析1994年6月至2000年3月间163例头颈部或颅底肿瘤患者接受碳离子放射治疗后视力保持的耐受剂量。对30例患者的54条视神经（ON）进行了分析，这些患者的ON已包含在照射体积中。这些患者没有表现出由于其他因素导致的视力损害的证据，并且随访期>4年。所有患者在治疗前均被告知可能存在视力损害。我们评估的剂量并发症的概率和预后因素的保留视力的碳离子放疗，使用剂量体积直方图和多变量analysis.Results：30例患者（14名男性，16名女性）的中位年龄为57.2岁。中位处方总剂量为56.0格雷当量（GyE），每天每部分3.0-4.0 GyE（范围：48-64 GyE; 16-18部分; 4-6周）。在分析的54例ON中，35例接受57 GyE（D-max）照射后视力下降。在所有这些病例中，ONs在碳离子放射治疗前已参与肿瘤。在多变量分析中，ON体积20%的剂量（D-20）与视力丧失显着相关。结论：视力丧失的发生似乎与向ON体积20%输送>60 GyE相关。（C）2006 Elsevier Inc.
Purpose: To analyze the tolerance dose for retention of visual acuity in patients with head-and-neck tumors treated with carbon ion radiotherapy.Methods and Materials: From June 1994 to March 2000, 163 patients with tumors in the head and neck or skull base region were-treated with carbon ion radiotherapy. Analysis was performed on 54 optic nerves (ONs) corresponding to 30 patients whose ONs had been included in the irradiated volume. These patients showed no evidence of visual impairment due to other factors and had a follow-up period of >4 years. All patients had been informed of the possibility of visual impairment before treatment. We evaluated the dose-complication probability and the prognostic factors for the retention of visual acuity in carbon ion radiotherapy, using dose-volume histograms and multivariate analysis.Results: The median age of 30 patients (14 men, 16 women) was 57.2 years. Median prescribed total dose was 56.0 gray equivalents (GyE) at 3.0-4.0 GyE per fraction per day (range, 48-64 GyE; 16-18 fractions; 4-6 weeks). Of 54 ONs that were analyzed, 35 had been irradiated with 57 GyE (D-max) suffered a decrease of visual acuity. In all of these cases, the ONs had been involved in the tumor before carbon ion radiotherapy. In the multivariate analysis, a dose of 20% of the volume of the ON (D-20) was significantly associated with visual loss.Conclusions: The occurrence of visual loss seems to be correlated with a delivery of >60 GyE to 20% of the volume of the ON. (C) 2006 Elsevier Inc.