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Effects on Periocular Tissues after Proton Beam Radiation Therapy for Intraocular Tumors.
J Korean Med Sci. 2018 Apr 16; 33(16):e120.JK

Abstract

BACKGROUND

To present our experience on orbital and periorbital tissue changes after proton beam radiation therapy (PBRT) in patients with intraocular tumors, apart from treatment outcomes and disease control.

METHODS

Medical records of 6 patients with intraocular tumors who had been treated with PBRT and referred to oculoplasty clinics of two medical centers (Seoul National University Hospital and Seoul Metropolitan Government-Seoul National University Boramae Medical Center) from October 2007 to September 2014 were retrospectively reviewed. The types of adverse effects associated with PBRT, their management, and progression were analyzed. In anophthalmic patients who eventually underwent enucleation after PBRT due to disease progression, orbital volume (OV) was assessed from magnetic resonance (MR) images using the Pinnacle3 program.

RESULTS

Among the six patients with PBRT history, three had uveal melanoma, and three children had retinoblastoma. Two eyes were treated with PBRT only, while the other four eyes ultimately underwent enucleation. Two eyes with PBRT only suffered from radiation dermatitis and intractable epiphora due to canaliculitis or punctal obstruction. All four anophthalmic patients showed severe enophthalmic features with periorbital hollowness. OV analysis showed that the difference between both orbits was less than 0.1 cm before enucleation, but increased to more than 2 cm³ after enucleation.

CONCLUSION

PBRT for intraocular tumors can induce various orbital and periorbital tissue changes. More specifically, when enucleation is performed after PBRT due to disease progression, significant enophthalmos and OV decrease can develop and can cause poor facial cosmesis as treatment sequelae.

Authors+Show Affiliations

Department of Ophthalmology, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea.Department of Ophthalmology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea. Department of Ophthalmology, College of Medicine, Seoul National University, Seoul, Korea .Department of Radiation Oncology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.Department of Ophthalmology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea. Department of Ophthalmology, College of Medicine, Seoul National University, Seoul, Korea. hokyung214@gmail.com.Department of Ophthalmology, Hallym University Sacred Heart Hospital, Anyang, Korea.Department of Ophthalmology, College of Medicine, Seoul National University, Seoul, Korea. Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, Korea.Department of Ophthalmology, College of Medicine, Seoul National University, Seoul, Korea. Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea.Department of Ophthalmology, College of Medicine, Seoul National University, Seoul, Korea. Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29651818

Citation

Choi, Youn Joo, et al. "Effects On Periocular Tissues After Proton Beam Radiation Therapy for Intraocular Tumors." Journal of Korean Medical Science, vol. 33, no. 16, 2018, pp. e120.
Choi YJ, Kim TW, Kim S, et al. Effects on Periocular Tissues after Proton Beam Radiation Therapy for Intraocular Tumors. J Korean Med Sci. 2018;33(16):e120.
Choi, Y. J., Kim, T. W., Kim, S., Choung, H., Lee, M. J., Kim, N., Khwarg, S. I., & Yu, Y. S. (2018). Effects on Periocular Tissues after Proton Beam Radiation Therapy for Intraocular Tumors. Journal of Korean Medical Science, 33(16), e120. https://doi.org/10.3346/jkms.2018.33.e120
Choi YJ, et al. Effects On Periocular Tissues After Proton Beam Radiation Therapy for Intraocular Tumors. J Korean Med Sci. 2018 Apr 16;33(16):e120. PubMed PMID: 29651818.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects on Periocular Tissues after Proton Beam Radiation Therapy for Intraocular Tumors. AU - Choi,Youn Joo, AU - Kim,Tae Wan, AU - Kim,Suzy, AU - Choung,Hokyung, AU - Lee,Min Joung, AU - Kim,Namju, AU - Khwarg,Sang In, AU - Yu,Young Suk, Y1 - 2018/04/16/ PY - 2017/10/13/received PY - 2018/02/20/accepted PY - 2018/4/14/entrez PY - 2018/4/14/pubmed PY - 2018/10/3/medline KW - Intraocular Tumor KW - Proton Beam Radiation Therapy KW - Retinoblastoma KW - Uveal Melanoma SP - e120 EP - e120 JF - Journal of Korean medical science JO - J. Korean Med. Sci. VL - 33 IS - 16 N2 - BACKGROUND: To present our experience on orbital and periorbital tissue changes after proton beam radiation therapy (PBRT) in patients with intraocular tumors, apart from treatment outcomes and disease control. METHODS: Medical records of 6 patients with intraocular tumors who had been treated with PBRT and referred to oculoplasty clinics of two medical centers (Seoul National University Hospital and Seoul Metropolitan Government-Seoul National University Boramae Medical Center) from October 2007 to September 2014 were retrospectively reviewed. The types of adverse effects associated with PBRT, their management, and progression were analyzed. In anophthalmic patients who eventually underwent enucleation after PBRT due to disease progression, orbital volume (OV) was assessed from magnetic resonance (MR) images using the Pinnacle3 program. RESULTS: Among the six patients with PBRT history, three had uveal melanoma, and three children had retinoblastoma. Two eyes were treated with PBRT only, while the other four eyes ultimately underwent enucleation. Two eyes with PBRT only suffered from radiation dermatitis and intractable epiphora due to canaliculitis or punctal obstruction. All four anophthalmic patients showed severe enophthalmic features with periorbital hollowness. OV analysis showed that the difference between both orbits was less than 0.1 cm before enucleation, but increased to more than 2 cm³ after enucleation. CONCLUSION: PBRT for intraocular tumors can induce various orbital and periorbital tissue changes. More specifically, when enucleation is performed after PBRT due to disease progression, significant enophthalmos and OV decrease can develop and can cause poor facial cosmesis as treatment sequelae. SN - 1598-6357 UR - https://www.unboundmedicine.com/medline/citation/29651818/Effects_on_Periocular_Tissues_after_Proton_Beam_Radiation_Therapy_for_Intraocular_Tumors L2 - https://jkms.org/DOIx.php?id=10.3346/jkms.2018.33.e120 DB - PRIME DP - Unbound Medicine ER -