Outcomes after cataract extraction in young children with radiation-induced cataracts and retinoblastoma

Hoehn, Mary Ellen; Irshad, Farhan A.; Kerr, Natalie C.; Wilson, Matthew W.

doi:10.1016/j.jaapos.2010.01.012

Cited by 23 publications

(21 citation statements)

References 8 publications

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“…Cataracts in younger children can lead to astigmatism and visual complications if left untreated, but the decision to undertake surgical repair is not trivial. Pediatric patients are subject to a higher rate of complications than their adult counterparts and a risk of blindness and enucleation exists due to infection, hemorrhage, and retinal detachment following repair 35,36 .…”

Section: Discussionmentioning

confidence: 99%

A dosimetric comparison of proton and intensity modulated radiation therapy in pediatric rhabdomyosarcoma patients enrolled on a prospective phase II proton study

Ladra

Edgington

Mahajan

et al. 2014

Radiotherapy and Oncology

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Background Pediatric rhabdomyosarcoma (RMS) is highly curable, however, cure may come with significant radiation related toxicity in developing tissues. Proton therapy (PT) can spare excess dose to normal structures, potentially reducing the incidence of adverse effects. Methods Between 2005 and 2012, 54 patients were enrolled on a prospective multi-institutional phase II trial using PT in pediatric RMS. As part of the protocol, intensity modulated radiation therapy (IMRT) plans were generated for comparison with clinical PT plans. Results Target coverage was comparable between PT and IMRT plans with a mean CTV V95 of 100% for both modalities (p=0.82). However, mean integral dose was 1.8 times higher for IMRT (range 1.0-4.9). By site, mean integral dose for IMRT was 1.8 times higher for H&N (p<0.01) and GU (p=0.02), 2.0 times higher for trunk/extremity (p<0.01), and 3.5 times higher for orbit (p<0.01) compared to PT. Significant sparing was seen with PT in 26 of 30 critical structures assessed for orbital, head and neck, pelvic, and trunk/extremity patients. Conclusions Proton radiation lowers integral dose and improves normal tissue sparing when compared to IMRT for pediatric RMS. Correlation with clinical outcomes is necessary once mature long-term toxicity data are available.

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Section: Discussionmentioning

confidence: 99%

A dosimetric comparison of proton and intensity modulated radiation therapy in pediatric rhabdomyosarcoma patients enrolled on a prospective phase II proton study

Ladra

Edgington

Mahajan

et al. 2014

Radiotherapy and Oncology

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“…EBRT also has an advantage over surgery by preserving the eye structure, which may result in a better appearance after treatment. The main concern with radiation therapy is damage to parts of the eye, leading to problems such as cataracts, retinal detachment, glaucoma, or bleeding into the eye [10–12]. …”

Section: Introductionmentioning

confidence: 99%

Dosimetric advantage of volumetric modulated arc therapy in the treatment of intraocular cancer

et al. 2017

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ObjectiveThe purpose of this study is to investigate the dosimetric advantages of volumetric modulated arc therapy (VMAT) in the treatment of intraocular cancer by comparing it directly with three-dimensional conformal radiotherapy (CRT) and intensity-modulated radiotherapy (IMRT).MethodsCRT plan, 7f-IMRT plan, and one-arc VMAT plan were generated for 14 intraocular cancer patients. Dosimetric and biological quality indices for target volume and organs at risks (OARs) were evaluated and compared.ResultsThe target coverage presented by V95 for CRT, IMRT and VMAT were 95.02% ± 0.67%, 95.51% ± 2.25%, and 95.92% ± 3.05%, respectively. The homogeneity index (HI) for CRT, IMRT and VMAT were 0.15 ± 0.05, 0.23 ± 0.05, and 0.23 ± 0.06, respectively. IMRT and VMAT greatly decreased the dose to ipsilateral lens compared with CRT with a D1 of 2972.66 ± 1407.12 cGy, 3317.82 ± 915.28 cGy and 4809.54 ± 524.60 cGy for IMRT, VMAT and CRT, respectively. Similar results were observed for ipsilateral eyeballs. IMRT and VMAT also spared better on brainstem, optical nerves and optical chiasm compared CRT. However, CRT achieved lower dose to the eyeballs compared with IMRT and VMAT. VMAT and IMRT showed mixed results on target coverage and OAR sparing. The average MUs and delivery time of IMRT and VMAT were 531.25 ± 81.21 vs. 400.99 ± 61.49 and 5.05 ± 0.53 vs.1.71 ± 0.69 min, respectively.ConclusionsAlthough no clear distinction on PTV coverage among CRT, IMRT and VMAT plans was observed in the treatment of intraocular cancer, VMAT and IMRT achieved better homogeneity and conformity for target volume, and delivered fewer doses to ipsilateral lens and eyeballs compared with CRT. However, VMAT and IMRT increased the low dose volume to the contralateral OARs. Although VMAT and IMRT showed mixed results on target coverage and OAR sparing, VMAT decreased MU and delivery time significantly compared with IMRT. VMAT is a promising and feasible external beam radiotherapy technique in the treatment of intraocular cancer patients.

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“…The data from Table 1 suggests that visual outcomes in these patients can be surprisingly excellent. In particular, the studies by Miller et al (2005), Payne et al (2008), and Hoehn et al (2010) reported good visual results and no major complications. Patients in this population have many other reasons to have poor visual outcomes including tumor involvement of the macula, radiation retinopathy, progressive retinal scarring from laser or cryotherapy treatments, and amblyopia.…”

Section: Visual Resultsmentioning

confidence: 90%

“…Payne et al (2008) also reported good results with an ECCE approach with a capsulotomy, anterior vitrectomy, and IOL placed only in some patients. In contrast, Hoehn et al (2010) reported outstanding results with only a lens aspiration and IOL with no posterior capsulotomy, deferring this procedure to a later EUA when needed. The major concern for patients undergoing any intraocular procedure who have a history of retinoblastoma is tumor recurrence or the development of metastatic disease as a result of the surgery.…”

Section: Surgical Approach and Complicationsmentioning

confidence: 99%

Cataract Surgery in Patients with a History of Retinoblastoma and Melanoma

Schefler¹,

Murray²

2013

Cataract Surgery

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Outcomes after cataract extraction in young children with radiation-induced cataracts and retinoblastoma

Cited by 23 publications

References 8 publications

A dosimetric comparison of proton and intensity modulated radiation therapy in pediatric rhabdomyosarcoma patients enrolled on a prospective phase II proton study

A dosimetric comparison of proton and intensity modulated radiation therapy in pediatric rhabdomyosarcoma patients enrolled on a prospective phase II proton study

Dosimetric advantage of volumetric modulated arc therapy in the treatment of intraocular cancer

Cataract Surgery in Patients with a History of Retinoblastoma and Melanoma

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