[Changes of visual field and visual evoked potential in nasopharyngeal carcinoma patients after radiotherapy].
OBJECTIVE
Radiotherapy is the main treatment for nasopharyngeal carcinoma (NPC). The incidence of radiation-induced complications, especially radiation optic neuropathy (RON), increases along with prolonging survival time of the patients. This study was to investigate RON in NPC patients after irradiation by visual field and visual evoked potential (VEP) tests.


METHODS
A total of 28 NPC patients, who underwent conventional external-beam irradiation, received visual field and VEP tests before irradiation, at the end of irradiation, and 5 years after irradiation.


RESULTS
Thirty-four (60.7%) eyes in 21 patients developed pathological visual field; 15 (44.1%) of these 34 eyes occurred within 10-24 months after irradiation. Of the 34 eyes, 8 showed concentric visual field constriction; 6 showed bitemporal hemianopia; 8 showed local photosensitivity descend; 10 showed central or cecocentral scotoma; 2 showed scotoma enlargement. Forty-four (78.6%) eyes in 26 patients appeared VEP abnormity; 24 (54.5%) of these 44 eyes occurred within 14 months after irradiation. In small, medium, and large elements, VEP latencies were significantly longer within 1 year after irradiation than pre-irradiation (P < 0.001, P < 0.001, and P=0.001); VEP amplitudes were lower within 1 year after irradiation than pre-irradiation without significant difference (P=0.249, P=0.940, and P=0.450). One year after treatment, VEP latency delay maintained in each element (P=0.004, P < 0.001, P < 0.001); VEP amplitudes were decreased (P=0.002, P=0.189, P < 0.001). The incidence of pathologic visual field was significantly lower in patients received irradiation of < or =70 Gy than in patients received irradiation of > 70 Gy (50.0% vs. 77.3%, P=0.041).


CONCLUSIONS
RON correlates to total irradiation dose. Pathologic visual field may indicate the position of RON.
Pan
Yi
Y
Department of Radiation Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, P. R. China.
Hu
Wei-Han
WH
Gao
Yi
Y
Yu
Min-Zhong
MZ
Huang
Shi-Zhou
SZ
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000503:physiopathology / Q000532:radiotherapy*; D003037:Cobalt Radioisotopes / Q000009:adverse effects / Q000627:therapeutic use; D005074:Evoked Potentials, Visual / Q000528:radiation effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000503:physiopathology / Q000532:radiotherapy*; D011829:Radiation Dosage; D011867:Radioisotope Teletherapy / Q000009:adverse effects*; D014794:Visual Fields / Q000528:radiation effects*
D003037:Cobalt Radioisotopes