Risk factors for cataract after palladium-103 ophthalmic plaque radiation therapy.
OBJECTIVE
To examine how tumor characteristics and dose affect cataract development after plaque radiation therapy.


METHODS
Three hundred and eighty-four patients were diagnosed with uveal melanoma and treated with palladium-103 ((103)Pd) plaque radiation therapy. Of these, 282 (74%) inclusion met exclusion criteria for follow-up time, tumor location, and phakic status. Then patient-, ophthalmic-, and radiation-specific factors (patient age, diabetes, hypertension, tumor location, tumor dimensions, and lens dose) were examined (by a Cox proportional regression model) as predictors for the development of radiation-related cataract.


RESULTS
Radiation cataract developed in 76 (24%) of patients at a mean follow-up of 39.8 months (range, 1-192). Patients with anteriorly located tumors were noted to have a higher incidence of cataract at 43.0% (43 of 100 patients) vs. 18.1% (33 cataracts per 182 patients) for posteriorly located tumors (p <0.0001). However, multivariate Cox proportional modeling showed that increasing patient age at time of treatment (p for trend = 0.0003) and higher lens dose (p for trend = 0.001) were the best predictors (biomarkers) for radiation cataract.


CONCLUSIONS
Although anterior tumor location, greater tumor height, and increased patient age (at treatment) were associated with significantly greater risk for radiation cataract, dose to lens was the most significant factor.
Finger
Paul T
PT
The New York Eye Cancer Center, New York, NY 10065, USA.
Chin
Kimberly J
KJ
Yu
Guo-Pei
GP
Patel
Neil S
NS
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects* / Q000379:methods; D002386:Cataract / Q000209:etiology*; D003920:Diabetes Mellitus; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications; D007908:Lens, Crystalline; D008545:Melanoma / Q000473:pathology / Q000532:radiotherapy; D008875:Middle Aged; D010165:Palladium / Q000009:adverse effects*; D016016:Proportional Hazards Models; D011832:Radiation Injuries / Q000150:complications; D011868:Radioisotopes / Q000009:adverse effects*; D011879:Radiotherapy Dosage; D012307:Risk Factors; D047368:Tumor Burden; D014604:Uveal Neoplasms / Q000473:pathology / Q000532:radiotherapy; D000098943:Uveal Melanoma
D011868:Radioisotopes; D010165:Palladium