X-Ray Irradiation of Orbital Glands of the Rabbit

Cogan, David G.; Fink, R.; Donaldson, David I.

doi:10.1148/64.5.731

Cited by 9 publications

(1 citation statement)

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“…Radiation-induced lacrimal gland damage has previously been demonstrated by histopathology. Cogan et al [13] originally reported a decrease in lacrimal gland size with increasing radiation dose ranging from 10.0 to 40.0 Gy in rabbits. Karp et al [14] studied human specimens from orbital exenterations and found persistent involutional atrophy of the lacrimal gland in a patient who had received 69.0 Gy with chronic keratoconjunctivitis, cataract, entropion and decreased tear fluid production on Schirmer's test.…”

Section: Discussionmentioning

confidence: 99%

Clinical-dosimetric relationship between lacrimal gland dose and ocular toxicity after intensity-modulated radiotherapy for sinonasal tumours

Batth

Sreeraman

Dienes

et al. 2013

BJR

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ME, Cui J, et al. Clinical-dosimetric Objective: To characterise the relationship between lacrimal gland dose and ocular toxicity among patients treated by intensity-modulated radiotherapy (IMRT) for sinonasal tumours. Methods: 40 patients with cancers involving the nasal cavity and paranasal sinuses were treated with IMRT to a median dose of 66.0 Gy. Toxicity was scored using the Radiation Therapy Oncology Group morbidity criteria based on conjunctivitis, corneal ulceration and keratitis. The paired lacrimal glands were contoured as organs at risk, and the mean dose, maximum dose, V 10 , V 20 and V 30 were determined. Statistical analysis was performed using logistic regression and the Akaike information criterion (AIC). Results:The maximum and mean dose to the ipsilateral lacrimal gland were 19.2 Gy (range, 1.4-75.4 Gy) and 14.5 Gy (range, 11.1-67.8 Gy), respectively. The mean V 10 , V 20 and V 30 values were 50%, 25% and 17%, respectively. The incidence of acute and late Grade 31 toxicities was 23% and 19%, respectively. Based on logistic regression and AIC, the maximum dose to the ipsilateral lacrimal gland was identified as a more significant predictor of acute toxicity (AIC, 53.89) and late toxicity (AIC, 32.94) than the mean dose (AIC, 56.13 and 33.83, respectively). The V 20 was identified as the most significant predictor of late toxicity (AIC, 26.81). Conclusion: A dose-response relationship between maximum dose to the lacrimal gland and ocular toxicity was established. Our data suggesting a threshold relationship may be useful in establishing dosimetric guidelines for IMRT planning that may decrease the risk of acute and late lacrimal toxicities in the future. Advances in knowledge: A threshold relationship between radiation dose to the lacrimal gland and ocular toxicity was demonstrated, which may aid in treatment planning and reducing the morbidity of radiotherapy for sinonasal tumours.

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Section: Discussionmentioning

confidence: 99%