Paul T Finger1, Kimberly J Chin, Guo-Pei Yu. 1. The New York Eye Cancer Center, New York, New York; The New York Eye and Ear Infirmary, New York, NY 10065, USA. pfinger@eyecancer
Abstract
PURPOSE: To determine how tumor characteristics and radiation dose affect the incidence of radiation maculopathy (RM). DESIGN: Retrospective, consecutive case series. METHODS: A consecutive case series of 384 uveal melanomas irradiated (mean apical dose, 71.2 Gy) were followed up for a mean 47.2 months. Tumor locations included: 122 (32%) centered anterior to the equator, 27 (7%) equatorial, and 235 (61%) posterior. Tumor sizes were American Joint Committee on Cancer class T1 (n = 180), T2 (n = 150), T3 (n = 47), and T4 (n = 7). RESULTS: RM occurred in 8 (7%) eyes with anterior uveal melanomas. In contrast, it was found in 82 (41%) eyes with posterior tumors. Multivariate analysis revealed the risk related to posterior location was greater compared with anterior location with a hazard ratio of 6.66 (95% confidence interval [CI], 4.94 to 22.50; P = .0001). Tumor height (> 6.0 mm) also demonstrated a high risk for RM (hazard ratio, 4.5; 95% CI, 2.68 to 10.17; P = .0001). A significant dose-response relationship was found between dose to fovea and RM (P = .0005, for trend). As compared with a dose of < 35 Gy, the risk of RM was 1.74 (95% CI, 0.98 to 3.1) for doses from 35 to 70 Gy, and the risk of RM was 2.43 (95% CI, 1.48 to 4.0) for doses of 70 Gy or more. Of interest, those anterior melanomas with RM had a mean apical height of 9.4 mm, as compared with a mean height of 3.3 mm for anterior tumors not associated with RM. Visual acuity was preserved if the fovea dose was less than 35 Gy. CONCLUSIONS: This study suggests that tumor location, tumor thickness, and radiation dose to the fovea are risk factors for the development of RM. Copyright 2010 Elsevier Inc. All rights reserved.
PURPOSE: To determine how tumor characteristics and radiation dose affect the incidence of radiation maculopathy (RM). DESIGN: Retrospective, consecutive case series. METHODS: A consecutive case series of 384 uveal melanomas irradiated (mean apical dose, 71.2 Gy) were followed up for a mean 47.2 months. Tumor locations included: 122 (32%) centered anterior to the equator, 27 (7%) equatorial, and 235 (61%) posterior. Tumor sizes were American Joint Committee on Cancer class T1 (n = 180), T2 (n = 150), T3 (n = 47), and T4 (n = 7). RESULTS: RM occurred in 8 (7%) eyes with anterior uveal melanomas. In contrast, it was found in 82 (41%) eyes with posterior tumors. Multivariate analysis revealed the risk related to posterior location was greater compared with anterior location with a hazard ratio of 6.66 (95% confidence interval [CI], 4.94 to 22.50; P = .0001). Tumor height (> 6.0 mm) also demonstrated a high risk for RM (hazard ratio, 4.5; 95% CI, 2.68 to 10.17; P = .0001). A significant dose-response relationship was found between dose to fovea and RM (P = .0005, for trend). As compared with a dose of < 35 Gy, the risk of RM was 1.74 (95% CI, 0.98 to 3.1) for doses from 35 to 70 Gy, and the risk of RM was 2.43 (95% CI, 1.48 to 4.0) for doses of 70 Gy or more. Of interest, those anterior melanomas with RM had a mean apical height of 9.4 mm, as compared with a mean height of 3.3 mm for anterior tumors not associated with RM. Visual acuity was preserved if the fovea dose was less than 35 Gy. CONCLUSIONS: This study suggests that tumor location, tumor thickness, and radiation dose to the fovea are risk factors for the development of RM. Copyright 2010 Elsevier Inc. All rights reserved.
Authors: Mark J Rivard; Sou-Tung Chiu-Tsao; Paul T Finger; Ali S Meigooni; Christopher S Melhus; Firas Mourtada; Mary E Napolitano; D W O Rogers; Rowan M Thomson; Ravinder Nath Journal: Med Phys Date: 2011-01 Impact factor: 4.071
Authors: Irena Tsui; Robert M Beardsley; Tara A McCannel; Scott C Oliver; Melissa W Chun; Steve P Lee; Phillip E Chow; Nzhde Agazaryan; Fei Yu; Bradley R Straatsma Journal: Open Ophthalmol J Date: 2015-06-26
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