J Korean Med Sci.
2018 Apr;33(16):e120. 10.3346/jkms.2018.33.e120.
Effects on Periocular Tissues after Proton Beam Radiation Therapy for Intraocular Tumors
- Affiliations
-
- 1Department of Ophthalmology, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea.
- 2Department of Ophthalmology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea. hokyung214@gmail.com
- 3Department of Ophthalmology, College of Medicine, Seoul National University, Seoul, Korea .
- 4Department of Radiation Oncology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.
- 5Department of Ophthalmology, Hallym University Sacred Heart Hospital, Anyang, Korea.
- 6Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, Korea .
- 7Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea.
- KMID: 2408664
- DOI: http://doi.org/10.3346/jkms.2018.33.e120
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.
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