Radiation optic neuropathy after megavoltage external-beam irradiation: analysis of time-dose factors

Parsons, James T.; Bova, Francis J.; Fitzgerald, Constance R.; Mendenhall, William M.; Million, Rodney R.

doi:10.1016/0360-3016(94)90346-8

Cited by 327 publications

(180 citation statements)

References 26 publications

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“…This opened up a new era of RT in pONSM. As with earlier reports, RT rarely caused significant tumor shrinkage on imaging, [65][66][67][68][69][70] a frequent reason for surgeons not to recommend RT in cases of rapid visual decline but to recommend surgery to immediately alleviate pressure to visual pathways. 75,76 However, it must be clearly stated that improvement in visual function can occur even during the course of RT, 77 as well as later on in the follow-up period, in neither case dependent on tumor shrinkage, but rather RT-induced edema decrease and ''decompression'' of the functional nerve structures.…”

Section: Treatmentsupporting

confidence: 64%

“…64,65 If the total dose increases to 54 Gy, the risk of optic neuropathy rises to roughly 5%. 66,67 However, in the study on head and neck cancer 67 with a dose of <59 Gy no injury was observed in 106 optic nerves. With 60 Gy, the 15-year actuarial risk of developing optic neuropathy was 47% with fraction sizes of 1.9 Gy, but was only 11% with fraction sizes <1.9 Gy.…”

Section: Treatmentmentioning

confidence: 93%

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Primary optic nerve sheath meningioma

Jeremić

Pitz

2007

Cancer

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Biotechnological production of weak organic acids such as succinic acid is most economically advantageous when carried out at low pH. Among naturally occurring microorganisms, several bacterial strains are known to produce considerable amounts of succinic acid under anaerobic conditions but they are inefficient in performing the low‐pH fermentation due to their physiological properties. We have proposed therefore a new strategy for construction of an aerobic eukaryotic producer on the basis of the yeast Yarrowia lipolytica with a deletion in the gene coding one of succinate dehydrogenase subunits. Firstly, an original in vitro mutagenesis‐based approach was proposed to construct strains with Ts mutations in the Y. lipolytica SDH1 gene. These mutants were used to optimize the composition of the media for selection of transformants with the deletion in the Y. lipolytica SDH2 gene. Surprisingly, the defects of each succinate dehydrogenase subunit prevented the growth on glucose but the mutant strains grew on glycerol and produced succinate in the presence of the buffering agent CaCO3. Subsequent selection of the strain with deleted SDH2 gene for increased viability allowed us to obtain a strain capable of accumulating succinate at the level of more than 45 g L−1 in shaking flasks with buffering and more than 17 g L−1 without buffering. The possible effect of the mutations on the utilization of different substrates and perspectives of constructing an industrial producer is discussed. Biotechnol. Bioeng. 2010;107:673–682. © 2010 Wiley Periodicals, Inc.

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Section: Treatmentsupporting

confidence: 64%

Section: Treatmentmentioning

confidence: 93%

Primary optic nerve sheath meningioma

Jeremić

Pitz

2007

Cancer

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“…Brada et al reported a need for hormonal replacement therapy in 30% and 50% of patients 10 and 19 years after radiotherapy 16 . Optic neuropathy is a serious complication, but it is rare after fractionated radiotherapy to doses of 45-54 Gy; Parsons et al reported no optic nerve injuries in 106 optic nerves that received a total radiation dose of less than 59 Gy 17 . The reported risk of optic neuropathy after fractionated radiotherapy for pituitary adenomas lies between 1% and 5% 3 .…”

Section: Discussionmentioning

confidence: 99%

Fractionated Stereotactic Radiotherapy in the Treatment of Pituitary Macroadenomas

et al. 2008

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BackgroundThe use of fractionated stereotactic radiotherapy (FSRT) has evolved with technical advances in noninvasive immobilization, radiation delivery, and image guidance. The application of FSRT to pituitary tumours is aimed at reducing toxicity through improved dose conformality and reduced treatment margins. The aim of the present paper is to report our own experience and to review the published data on FSRT for pituitary macroadenomas. MethodsBetween September 2000 and October 2005, 13 patients with pituitary macroadenoma underwent FSRT at our institution. In 12 patients, radiotherapy treatment followed surgical resection (transsphenoidal resection in 8, frontal craniotomy in 3, and multiple transsphenoidal resections followed by craniotomy in 1). In 4 patients, the tumours were functional (2 adrenocorticotropic hormone-secreting, 1 prolactinoma, and 1 growth hormone-secreting); the tumours in the remaining patients were clinically non-secretory. Before radiation, 3 patients had panhypopituitarism, and 6 patients had visual field defects. All patients were treated with FSRT using non-coplanar micro-multileaf collimation portals. A median dose of 50.4 Gy (range: 45-60 Gy) was prescribed to the 76.9%-95.2% isodose surface and delivered in 1.8-Gy fractions. The median planning target volume (gross tumour plus 3 mm) was 33.5 cm 3 (range: 3.2-75 cm 3 ). ResultsAfter a median follow-up of 24 months (range: 6-60 months), local control was 100%. One patient achieved clinical complete response. Treatment was well tolerated acutely for all patients. Neither radiation-induced optic neuropathy nor any radiation-related endocrine dysfunction was observed in our patients. ConclusionsIn accordance with published series, we found FSRT to be safe and effective in the management of large pituitary macroadenomas.

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“…Radiation therapy is often performed in patients with unresectable cancer or patients in whom surgery is considered difficult because of older age or comorbidities. However, since 1992, the efficacy of CRT has been well documented, and CRT has been clearly shown to improve cure rates compared with radiotherapy alone [1,2,[5][6][7][8][9]. Currently, the guidelines of the National Comprehensive Cancer Network recommend CRT for esophageal cancer such as medically unfit for surgery or surgery not elected case [3].…”

Section: Discussionmentioning

confidence: 99%

Buffer Optimization for Cynodon dactylon Proteome

Tahir¹,

Shakeel²

2012

J Proteomics Bioinform

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Purpose: To evaluate the treatment outcomes of chemoradiotherapy for patients with advanced esophageal cancer and estimate the prognostic factors. Materials and methods:Patients with advanced esophageal cancer, who were treated with chemoradiotherapy (CRT) between April 2003 and December 2010, were evaluated. Patients received concurrent chemoradiotherapy (cisplatin plus 5-fluorouracil and 61.2 Gy radiotherapy). Therapeutic response, overall survival time, and toxicity were examined and statistical evaluation was performed.Results: One hundred and fourteen patients were treated with CRT. Among them, 84 patients (77.2%) received the complete course of CRT. Eighteen patients (15.8%) had a complete response, 90 patients (78.9%) had a partial response and 6 patients (5.3%) exhibited progressive disease. The mean follow-up period was 14.6 months (range, 2-90 months). The median overall survival time was 13.0 months. The 2-year and 3-year overall survival rates were 38.1% and 19.2%, respectively. Severe hematological toxicities included Grade 3 leukopenia in 40 patients (35.1%). Treatment-related death was estimated to have occurred in 7 patients. Performance status and body weight loss were identified as significant prognostic factors. Conclusion:In our study, PS and body weight loss showed prognostic factors in CRT for advanced esophageal cancer.

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Radiation optic neuropathy after megavoltage external-beam irradiation: analysis of time-dose factors

Cited by 327 publications

References 26 publications

Primary optic nerve sheath meningioma

Primary optic nerve sheath meningioma

Fractionated Stereotactic Radiotherapy in the Treatment of Pituitary Macroadenomas

Buffer Optimization for Cynodon dactylon Proteome

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