Lacrimal gland radiosensitivity in uveal melanoma patients.
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.
Muller
Karin
K
Department of Radiation-Oncology, Erasmus Medical Center, Rotterdam, The Netherlands. k.muller@erasmusmc.nl
Nowak
Peter J C M
PJ
Naus
Nicole
N
de Pan
Connie
C
van Santen
Cornelis A
CA
Levendag
Peter
P
Luyten
Gré P M
GP
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*