Single- and Multi-Fraction Stereotactic Radiosurgery Dose Tolerances of the Optic Pathways.
Adenoma
/ radiotherapy
Blindness
/ etiology
Cavernous Sinus
Craniopharyngioma
/ radiotherapy
Humans
Maximum Tolerated Dose
Meningeal Neoplasms
/ radiotherapy
Meningioma
/ radiotherapy
Models, Biological
Models, Theoretical
Optic Chiasm
/ radiation effects
Optic Nerve
/ radiation effects
Organs at Risk
/ radiation effects
Pituitary Neoplasms
/ radiotherapy
Radiation Dose Hypofractionation
Radiation Tolerance
Radiosurgery
/ adverse effects
Radiotherapy Dosage
Re-Irradiation
Skull Base Neoplasms
/ radiotherapy
Visual Acuity
/ radiation effects
Visual Fields
/ radiation effects
Journal
International journal of radiation oncology, biology, physics
ISSN: 1879-355X
Titre abrégé: Int J Radiat Oncol Biol Phys
Pays: United States
ID NLM: 7603616
Informations de publication
Date de publication:
01 05 2021
01 05 2021
Historique:
received:
27
11
2017
revised:
11
01
2018
accepted:
16
01
2018
pubmed:
15
3
2018
medline:
5
8
2021
entrez:
15
3
2018
Statut:
ppublish
Résumé
Dosimetric and clinical predictors of radiation-induced optic nerve/chiasm neuropathy (RION) after single-fraction stereotactic radiosurgery (SRS) or hypofractionated (2-5 fractions) radiosurgery (fSRS) were analyzed from pooled data that were extracted from published reports (PubMed indexed from 1990 to June 2015). This study was undertaken as part of the American Association of Physicists in Medicine Working Group on Stereotactic Body Radiotherapy, investigating normal tissue complication probability (NTCP) after hypofractionated radiation. Eligible studies described dose delivered to optic nerve/chiasm and provided crude or actuarial toxicity risks, with visual endpoints (ie, loss of visual acuity, alterations in visual fields, and/or blindness/complete vision loss). Studies of patients with optic nerve sheath tumors, optic nerve gliomas, or ocular/uveal melanoma were excluded to obviate direct tumor effects on visual outcomes, as were studies not specifying causes of vision loss (ie, tumor progression vs RION). Thirty-four studies (1578 patients) were analyzed. Histologies included pituitary adenoma, cavernous sinus meningioma, craniopharyngioma, and malignant skull base tumors. Prior resection (76% of patients) did not correlate with RION risk (P = .66). Prior irradiation (6% of patients) was associated with a crude 10-fold increased RION risk versus no prior radiation therapy. In patients with no prior radiation therapy receiving SRS/fSRS in 1-5 fractions, optic apparatus maximum point doses resulting in <1% RION risks include 12 Gy in 1 fraction (which is greater than our recommendation of 10 Gy in 1 fraction), 20 Gy in 3 fractions, and 25 Gy in 5 fractions. Omitting multi-fraction data (and thereby eliminating uncertainties associated with dose conversions), a single-fraction dose of 10 Gy was associated with a 1% RION risk. Insufficient details precluded modeling of NTCP risks after prior radiation therapy. Optic apparatus NTCP and tolerance doses after single- and multi-fraction stereotactic radiosurgery are presented. Additional standardized dosimetric and toxicity reporting is needed to facilitate future pooled analyses and better define RION NTCP after SRS/fSRS.
Identifiants
pubmed: 29534899
pii: S0360-3016(18)30125-1
doi: 10.1016/j.ijrobp.2018.01.053
pmc: PMC9479557
mid: NIHMS1829028
pii:
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
87-99Subventions
Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States
Informations de copyright
Copyright © 2018 Elsevier Inc. All rights reserved.
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