1Department of Radiation Oncology, Ege University Faculty of Medicine, Izmir, Turkey
2Department of Ophthalmology, Ege University Faculty of Medicine, Izmir, Turkey
Copyright © 2022 by the Korean Cancer Association
This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Ethical Statement
Written informed consent was taken from all patients, and instructional review board approval was gathered from the Ege University Ethics Committee with protocol number 1226/474.
Author Contributions
Conceived and designed the analysis: Akagunduz OO, Yilmaz SG, Tavlayan E.
Collected the data: Akagunduz OO, Yilmaz SG, Tavlayan E, Baris ME.
Contributed data or analysis tools: Akagunduz OO, Yilmaz SG, Afrashi F.
Performed the analysis: Akagunduz OO, Afrashi F, Esassolak M.
Wrote the paper: Akagunduz OO, Yilmaz SG, Baris ME.
Conflict of interest
Conflict of interest relevant to this article was not reported.
Patient characteristics
Characteristic | No. (%) (n=19) |
---|---|
Age, median (range, yr) | 45 (19–70) |
Sex | |
Female | 8 (42) |
Male | 11 (58) |
Primary site | |
Nasal cavity | 8 (42) |
Paranasal sinus | 7 (37) |
Nasopharynx | 3 (16) |
Skin | 1 (5) |
Stage | |
II | 6 (32) |
III | 8 (42) |
IVA | 5 (26) |
Chemotherapy | |
None | 1 (5) |
Concurrent chemoradiotherapy | 16 (84) |
Induction chemotherapy followed by concurrent chemoradiotherapy | 2 (11) |
Radiotherapy (VMAT) | |
Adjuvant 60–66 Gy (2–2.06 Gy/fx) | 15 (79) |
Definitive 70 Gy (2.12 Gy/fx) | 4 (21) |
Comorbidity | |
Diabetes mellitus | 8 (42) |
Hypertension | 10 (53) |
Alcohol consumption | 9 (47) |
VMAT, volumetric modulated arc therapy.
Subgroup patients who received radiotheraphy above tolerance doses on optic nerve and/or eyeball
Patient (eye) | Lakrimal gland Dmean | Cornea Dmean | Retina Dmean | Retina D10 | Optic nerve D5 | Optic nerve Dmax | Chiasm Dmax |
---|---|---|---|---|---|---|---|
1 (right) | 35 | 50 | 53 | 65 | 58 | 60 | 61 |
2 (left) | 17 | 36 | 36 | 67 | 70 | 71 | 56 |
3 (right) | 30 | 45 | 49 | 62 | 58 | 58 | 50 |
4 (right) | 33 | 49 | 53 | 69 | 70 | 71 | 53 |
5 (left) | 15 | 53 | 47 | 65 | 50 | 52 | 36 |
6 (right) | 26 | 44 | 47 | 65 | 70 | 71 | 56 |
7 (right) | 25 | 38 | 41 | 61 | 54 | 54 | 56 |
8 (right) | 12 | 15 | 20 | 46 | 66 | 68 | 55 |
D5, highest dose to 5% of the volume; D10, highest dose to 10% of the volume; Dmax, maximum dose; Dmean, mean dose.
Subgroup patients: VA, VF, CS, and VEP tests before the radiotherapy of the patients and after the treatment at 24th month, and 36th month for VA
Patient (eye) | VA 0 | VA 6 | VA 12 | VA 24 | VA 36 | VF 0 | VF 24 | CS 0 | CS 24 | VL 0 | VL24 | VA 0 | VA 24 |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1 (right) | 1 | 0.9 | 0.9 | 0.1 | NLP | 2 | 3 | 2 | 3 | 120 | 117 | 5.1 | 3.6 |
2 (left) | 1 | 1 | 1 | 0.4 | 0.1 | 2 | 2 | 2 | 2 | 105 | 106 | 12.1 | 10.7 |
3 (right) | 0.8 | 0.7 | 0.4 | 0.3 | 0.1 | 1 | 3 | 2 | 3 | 121 | 128 | 9.5 | 1.7 |
4 (right) | 1 | 0.8 | 0.8 | NLP | NLP | 2 | - | 2 | - | 112 | 128 | 10.7 | - |
5 (left) | 1 | 0.8 | NLP | NLP | NLP | 1 | - | 1 | - | 109 | - | 4.7 | - |
6 (right) | 0.9 | 0.1 | 0.1 | NLP | NLP | 1 | - | 1 | - | 103 | - | 3.0 | - |
7 (right) | 1 | 1 | 1 | 1 | 0.7 | 1 | 2 | 1 | 1 | 103 | 102 | 8.2 | 6.1 |
8 (right) | 1 | 1 | 1 | 1 | 0.8 | 1 | 1 | 1 | 1 | 102 | 103 | 8.5 | 8.5 |
CS, contrast sensitivity (grade); NLP, no light perception; VA, visual acuity; VEP, visual evoked potential; VF, visual field (grade).
Subgroup patients: the ophthalmologic examination findings
Patient (eye) | Dry eye severety levels | Retinopathy | Other ocular complications | Treatment |
---|---|---|---|---|
1 (right) | Severe | − | Keratitis and cataract | Ocular lubricants, artificial tear drops, anti-inflammatory agents, and cataract surgery |
2 (left) | Mild | + | Cataract | Ocular lubricants, artificial tear drops and intravitreal injection |
3 (right) | Modarete | − | − | Ocular lubricants, artificial tear drops, anti-inflammatory agents |
4 (right) | Modarate | + | + | Ocular lubricants, artificial tear drops, anti-inflammatory agents and intravitreal injection |
5 (left) | Modarate | + | Retinal detachment | Ocular lubricants, artificial tear drops, anti-inflammatory agents, considered as inoperable |
6 (right) | Severe | − | Corneal perforation | Ocular lubricants, artificial tear drops, anti-inflammatory agents and penetrating keratoplasty |
7 (right) | Mild | − | − | Ocular lubricants, artificial tear drops |
8 (right) | Mild | − | − | Ocular lubricants, artificial tear drops |
VMAT, volumetric modulated arc therapy.
D5, highest dose to 5% of the volume; D10, highest dose to 10% of the volume; Dmax, maximum dose; Dmean, mean dose.
CS, contrast sensitivity (grade); NLP, no light perception; VA, visual acuity; VEP, visual evoked potential; VF, visual field (grade).