Incidence of dry eye after radiotherapy for head and neck tumours: a tertiary Care Hospital North West Rajasthan

Purpose: To study the incidence of dry eye disease (DED) in head and neck cancer (HNC) patients undergoing external beam radiotherapy (EBRT), to find a correlation between tumor location and total radiation dose with DED, and to report various radiotherapy (RT) induced acute toxic effects on ocular and adnexal structures. Methods: A prospective cohort study was conducted at a tertiary eye-care center on 90 patients of HNC undergoing EBRT from March 2021 to May 2022. All underwent a thorough clinical history and complete ophthalmological examination including an ocular surface disease index (OSDI) questionnaire, visual acuity, anterior segment, angle and posterior segment examination, dry eye workup including the Schirmer test, tear meniscus height, tear break-up time, corneal fluorescein staining and grading, and meibography by auto-refractometer and its scoring at each visit. Patients were evaluated before the start of RT and then at 1 week, 4 weeks, and 12 weeks post-RT. Radiation records of all patients were noted. Data were analyzed using percentage and Microsoft Excel. Results: Of the 90 patients, 66 were male and 24 female (M: F ratio of 2.75) with a median age of 52.5 years (range 24 to 80 years). The most common HNC was the carcinoma oral cavity and lip. Most patients received a total radiation dose between 46 to 55 Gy. DED developed in 48 (53.3%) patients. The incidence of DED increased with the increase in total radiation dose (r = 0.987). DED was also found to be correlated with tumor location (r = 0.983). Conclusion: The incidence of DED positively correlated with the total radiation dose and tumor location.

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“…[ 14 ] and Jain et al . [ 21 ] Jiang et al . (1994) reported a 30% incidence of dry eye for doses >40 Gy.…”

Section: Discussionmentioning

confidence: 99%

Dry eye disease in head and neck cancer patients undergoing radiotherapy

Soni

Walia

Jain

2023

Indian Journal of Ophthalmology

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“…The study also suggested the importance of total dose as well as dose per fraction in causing DES in such patients. [12] Radiation also damages the limbal stem cells and can cause limbal ischemia in such patients leading to chronic non healing epithelial defect. In our study we found one patient who developed limbal ischemia.…”

Section: Discussionmentioning

confidence: 99%

Acute Toxic Effects of Ocular Surface and Adnexa Induced by External Beam Radiotherapy in Head and Neck Cancer Patients

Soni

Walia

2022

PIJR

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Head and neck cancers (HNC) are one of the commonest cancers in India. The primary treatment modality of these patients is either radiotherapy (RT) alone or combined surgical and radio/chemotherapy approach. RT of HNC leads to various acute and chronic ophthalmic complications. After approval from institutional ethics committee we conducted a prospective cohort study for a period of 3 months at a tertiary care center to find the incidence of various acute ophthalmic complications of radiotherapy in these patients specifically dry eye disease (DED) and also to correlate these findings with the total radiation dose (TRD). We recruited 40 patients "of HNC" undergoing. external beam radiotherapy by cobalt-60 machine. Patients were selected based on inclusion and exclusion criteria. Radiation records of all patients were noted. Patients were evaluated prior to start of RT and then at 1 week, 4 weeks and 12 weeks post RT. All underwent a thorough clinical history and complete ophthalmological examination including Ocular surface disease index (OSDI) questionnaire, visual acuity, anterior segment, angle and posterior segment examination, a complete dry eye work up including Schirmer test, tear meniscus height, tear break up time, corneal fluorescein staining & grading at each visit. Data was analysed using percentage and microsoft excel. Of the 40 patients; 24 (60%) were male and 16 (40%) were female (ratio1.5:1) and the median age of patients was 56 years with an age range of 35 to 63 years. Various acute complications found in our study were redness, madarosis, tylosis, limbal ischemia and dry eye disease (18 patients; 45%). We also found a strong positive correlation of DED with TRD. (r= 0.87)

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Incidence of dry eye after radiotherapy for head and neck tumours: a tertiary Care Hospital North West Rajasthan

Cited by 2 publications

References 8 publications

Dry eye disease in head and neck cancer patients undergoing radiotherapy

Dry eye disease in head and neck cancer patients undergoing radiotherapy

Acute Toxic Effects of Ocular Surface and Adnexa Induced by External Beam Radiotherapy in Head and Neck Cancer Patients

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