title: Lacrimal gland radiosensitivity in uveal melanoma patients.
abstract: OBJECTIVE
  To find a dose-volume effect for inhomogeneous irradiated lacrimal glands.
  
  
  METHODS
  Between 1999 and 2006, 72 patients (42 men and 30 women) were treated with fractionated stereotactic radiotherapy in a prospective, nonrandomized clinical trial (median follow-up, 32 months). A total dose of 50 Gy was given on 5 consecutive days. The mean of all Schirmer test results obtained > or =6 months after treatment was correlated with the radiation dose delivered to the lacrimal gland. Also, the appearance of dry eye syndrome (DES) was related to the lacrimal gland dose distribution.
  
  
  RESULTS
  Of the 72 patients, 17 developed a late Schirmer value <10 mm; 9 patients developed DES. A statistically significant relationship was found between the received median dose in the lacrimal gland vs. reduced tear production (p = 0.000) and vs. the appearance of DES (p = 0.003), respectively. A median dose of 7 Gy/fraction to the lacrimal gland caused a 50% risk of low Schirmer results. A median dose of 10 Gy resulted in a 50% probability of DES.
  
  
  CONCLUSIONS
  We found a clear dose-volume relationship for irradiated lacrimal glands with regard to reduced tear production and the appearance of DES.
authors.affiliation: Department of Radiation-Oncology, Erasmus Medical Center, Rotterdam, The Netherlands. k.muller@erasmusmc.nl
authors.forename: Karin
authors.initials: K
authors.lastname: Muller
authors.forename: Peter J C M
authors.initials: PJ
authors.lastname: Nowak
authors.forename: Nicole
authors.initials: N
authors.lastname: Naus
authors.forename: Connie
authors.initials: C
authors.lastname: de Pan
authors.forename: Cornelis A
authors.initials: CA
authors.lastname: van Santen
authors.forename: Peter
authors.initials: P
authors.lastname: Levendag
authors.forename: Gré P M
authors.initials: GP
authors.lastname: Luyten
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004307:Dose-Response Relationship, Radiation; D015352:Dry Eye Syndromes / Q000209:etiology*; D005260:Female; D006801:Humans; D007765:Lacrimal Apparatus / Q000528:radiation effects*; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000601:surgery*; D008875:Middle Aged; D011446:Prospective Studies; D011836:Radiation Tolerance; D016634:Radiosurgery / Q000009:adverse effects*; D012044:Regression Analysis; D013666:Tears / Q000378:metabolism; D014604:Uveal Neoplasms / Q000401:mortality / Q000601:surgery*