Predictive factors of radio‐induced complications in 194 eyes undergoing gamma knife radiosurgery for uveal melanoma
Background and purpose To report the factors predictive of radio‐induced complications (i.e. radiation retinopathy [RR], radiation papillopathy [RP] and neovascular glaucoma [NVG]) in uveal melanoma (UM) patients undergoing gamma knife radiosurgery (GKR). Materials and methods Longitudinal cohort st...
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| Veröffentlicht in: | Acta ophthalmologica (Oxford, England) England), 2021-12, Vol.99 (8), p.e1458-e1466 |
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| creator | Cicinelli, Maria Vittoria Di Nicola, Maura Gigliotti, Carmen Rosaria Battista, Marco Miserocchi, Elisabetta Vecchio, Antonella Mortini, Pietro Bandello, Francesco Modorati, Giulio Maria |
| description | Background and purpose
To report the factors predictive of radio‐induced complications (i.e. radiation retinopathy [RR], radiation papillopathy [RP] and neovascular glaucoma [NVG]) in uveal melanoma (UM) patients undergoing gamma knife radiosurgery (GKR).
Materials and methods
Longitudinal cohort study on patients with UM treated at the Ocular Oncology Service, San Raffaele Scientific Institute, Milan, between June 1994 and November 2018. Data were retrospectively reviewed. Rates of GKR‐related complications were reported. Variables associated with each complication were investigated using multivariable Cox models and confirmed by logistic regression analysis. Hazard ratio (HR) and 95% confidence intervals (CI) were reported for significant associations.
Results
One hundred ninety‐four patients (99 males, 51%) were included, and 184 tumours were primarily located in the choroid (95%). Median follow‐up was 57 months (range 6–286). Local control was achieved in 182 eyes (94%), and 152 eyes (78%) experienced at least one radiation‐induced complication. Radiation retinopathy was documented in 67 eyes (35%) after a median of 23 months. Older age (HR = 0.97, 95% CI = 0.95–0.99, p = 0.02) had a protective effect for RR. Radiation papillopathy was diagnosed in 35 eyes (18%) after a median of 14 months after GKR. Macular or peripapillary location (HR = 3.06, 95% CI = 1.52–6.16, p = 0.002) was associated with increased risk of RP, while older age was protective (HR = 0.95, 95% CI = 0.93–0.98, p = 0.001). New‐onset NVG was found in 53 eyes (27%), and median onset was 28 months. Tumour thickness (HR = 4.41, 95% CI = 2.23–8.72, p |
| doi_str_mv | 10.1111/aos.14814 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_2597363075</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2597363075</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3884-df6aa8f6678755d5bae44711ee24881bddd0353974a2655a7f875caa1cdb2ef63</originalsourceid><addsrcrecordid>eNp1kEtKBDEQQIMo_hdeQAKuXIx2uvObpYg_EBRUcNfUJJUh2t0Zk-mR2XkEz-hJjLa6M5vK4vGKeoTsseKI5XcMIR0xrhlfIZtMCTGqlNSrf3_xuEG2UnoqCsmk5Otko6pkpUulNsniNqL1Zu4XSB2YeYiJBkcjWB8-3t59Z3uDlprQzhpvYO5Dl6jvKBtziktMtO8sxmnw3ZROoW2BPnfe4SBIfZxiXFIXIu0XCA1tsYEutLBD1hw0CXd_5jZ5OD-7P70cXd9cXJ2eXI9MpTUfWScBtJNS6XyKFRNAzhVjiCXXmk2stUUlqrHiUEohQLnMGQBm7KREJ6ttcjB4ZzG89Jjm9VPoY5dX1qUYq5yhUCJThwNlYkgpoqtn0bcQlzUr6q_CdS5cfxfO7P6PsZ-0aP_I36QZOB6AV9_g8n9TfXJzNyg_AU_Vh-o</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2597363075</pqid></control><display><type>article</type><title>Predictive factors of radio‐induced complications in 194 eyes undergoing gamma knife radiosurgery for uveal melanoma</title><source>MEDLINE</source><source>Wiley Free Content</source><source>Wiley Online Library All Journals</source><creator>Cicinelli, Maria Vittoria ; Di Nicola, Maura ; Gigliotti, Carmen Rosaria ; Battista, Marco ; Miserocchi, Elisabetta ; Vecchio, Antonella ; Mortini, Pietro ; Bandello, Francesco ; Modorati, Giulio Maria</creator><creatorcontrib>Cicinelli, Maria Vittoria ; Di Nicola, Maura ; Gigliotti, Carmen Rosaria ; Battista, Marco ; Miserocchi, Elisabetta ; Vecchio, Antonella ; Mortini, Pietro ; Bandello, Francesco ; Modorati, Giulio Maria</creatorcontrib><description>Background and purpose
To report the factors predictive of radio‐induced complications (i.e. radiation retinopathy [RR], radiation papillopathy [RP] and neovascular glaucoma [NVG]) in uveal melanoma (UM) patients undergoing gamma knife radiosurgery (GKR).
Materials and methods
Longitudinal cohort study on patients with UM treated at the Ocular Oncology Service, San Raffaele Scientific Institute, Milan, between June 1994 and November 2018. Data were retrospectively reviewed. Rates of GKR‐related complications were reported. Variables associated with each complication were investigated using multivariable Cox models and confirmed by logistic regression analysis. Hazard ratio (HR) and 95% confidence intervals (CI) were reported for significant associations.
Results
One hundred ninety‐four patients (99 males, 51%) were included, and 184 tumours were primarily located in the choroid (95%). Median follow‐up was 57 months (range 6–286). Local control was achieved in 182 eyes (94%), and 152 eyes (78%) experienced at least one radiation‐induced complication. Radiation retinopathy was documented in 67 eyes (35%) after a median of 23 months. Older age (HR = 0.97, 95% CI = 0.95–0.99, p = 0.02) had a protective effect for RR. Radiation papillopathy was diagnosed in 35 eyes (18%) after a median of 14 months after GKR. Macular or peripapillary location (HR = 3.06, 95% CI = 1.52–6.16, p = 0.002) was associated with increased risk of RP, while older age was protective (HR = 0.95, 95% CI = 0.93–0.98, p = 0.001). New‐onset NVG was found in 53 eyes (27%), and median onset was 28 months. Tumour thickness (HR = 4.41, 95% CI = 2.23–8.72, p < 0.001) and peripapillary location (HR = 2.78, 95% CI = 1.46–5.27, p = 0.002) were the main risk factors associated with NVG.
Conclusion
Understanding factors predictive for radiation‐related complications in patients undergoing GKR might help for better counselling and treatment planning.</description><identifier>ISSN: 1755-375X</identifier><identifier>EISSN: 1755-3768</identifier><identifier>DOI: 10.1111/aos.14814</identifier><identifier>PMID: 33638277</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; choroidal melanoma ; Eye ; Female ; Follow-Up Studies ; gamma knife radiosurgery ; Glaucoma ; Humans ; Italy - epidemiology ; Male ; Melanoma ; Melanoma - radiotherapy ; Middle Aged ; neovascular glaucoma ; Patients ; Postoperative Complications - diagnosis ; Postoperative Complications - epidemiology ; Postoperative Complications - etiology ; Prognosis ; Radiation ; Radiation Injuries - diagnosis ; Radiation Injuries - epidemiology ; Radiation Injuries - etiology ; radiation papillopathy ; radiation retinopathy ; Radiosurgery ; Radiosurgery - adverse effects ; Radiosurgery - instrumentation ; radio‐induced complications ; Regression analysis ; Retinopathy ; Retrospective Studies ; Risk factors ; Time Factors ; Tumors ; uveal melanoma ; Uveal Neoplasms - radiotherapy ; Visual Acuity</subject><ispartof>Acta ophthalmologica (Oxford, England), 2021-12, Vol.99 (8), p.e1458-e1466</ispartof><rights>2021 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd</rights><rights>2021 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.</rights><rights>Copyright © 2021 Acta Ophthalmologica Scandinavica Foundation</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3884-df6aa8f6678755d5bae44711ee24881bddd0353974a2655a7f875caa1cdb2ef63</citedby><cites>FETCH-LOGICAL-c3884-df6aa8f6678755d5bae44711ee24881bddd0353974a2655a7f875caa1cdb2ef63</cites><orcidid>0000-0001-5940-6177 ; 0000-0003-3238-9682 ; 0000-0003-2938-0409</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Faos.14814$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Faos.14814$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,1433,27923,27924,45573,45574,46408,46832</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33638277$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cicinelli, Maria Vittoria</creatorcontrib><creatorcontrib>Di Nicola, Maura</creatorcontrib><creatorcontrib>Gigliotti, Carmen Rosaria</creatorcontrib><creatorcontrib>Battista, Marco</creatorcontrib><creatorcontrib>Miserocchi, Elisabetta</creatorcontrib><creatorcontrib>Vecchio, Antonella</creatorcontrib><creatorcontrib>Mortini, Pietro</creatorcontrib><creatorcontrib>Bandello, Francesco</creatorcontrib><creatorcontrib>Modorati, Giulio Maria</creatorcontrib><title>Predictive factors of radio‐induced complications in 194 eyes undergoing gamma knife radiosurgery for uveal melanoma</title><title>Acta ophthalmologica (Oxford, England)</title><addtitle>Acta Ophthalmol</addtitle><description>Background and purpose
To report the factors predictive of radio‐induced complications (i.e. radiation retinopathy [RR], radiation papillopathy [RP] and neovascular glaucoma [NVG]) in uveal melanoma (UM) patients undergoing gamma knife radiosurgery (GKR).
Materials and methods
Longitudinal cohort study on patients with UM treated at the Ocular Oncology Service, San Raffaele Scientific Institute, Milan, between June 1994 and November 2018. Data were retrospectively reviewed. Rates of GKR‐related complications were reported. Variables associated with each complication were investigated using multivariable Cox models and confirmed by logistic regression analysis. Hazard ratio (HR) and 95% confidence intervals (CI) were reported for significant associations.
Results
One hundred ninety‐four patients (99 males, 51%) were included, and 184 tumours were primarily located in the choroid (95%). Median follow‐up was 57 months (range 6–286). Local control was achieved in 182 eyes (94%), and 152 eyes (78%) experienced at least one radiation‐induced complication. Radiation retinopathy was documented in 67 eyes (35%) after a median of 23 months. Older age (HR = 0.97, 95% CI = 0.95–0.99, p = 0.02) had a protective effect for RR. Radiation papillopathy was diagnosed in 35 eyes (18%) after a median of 14 months after GKR. Macular or peripapillary location (HR = 3.06, 95% CI = 1.52–6.16, p = 0.002) was associated with increased risk of RP, while older age was protective (HR = 0.95, 95% CI = 0.93–0.98, p = 0.001). New‐onset NVG was found in 53 eyes (27%), and median onset was 28 months. Tumour thickness (HR = 4.41, 95% CI = 2.23–8.72, p < 0.001) and peripapillary location (HR = 2.78, 95% CI = 1.46–5.27, p = 0.002) were the main risk factors associated with NVG.
Conclusion
Understanding factors predictive for radiation‐related complications in patients undergoing GKR might help for better counselling and treatment planning.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>choroidal melanoma</subject><subject>Eye</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>gamma knife radiosurgery</subject><subject>Glaucoma</subject><subject>Humans</subject><subject>Italy - epidemiology</subject><subject>Male</subject><subject>Melanoma</subject><subject>Melanoma - radiotherapy</subject><subject>Middle Aged</subject><subject>neovascular glaucoma</subject><subject>Patients</subject><subject>Postoperative Complications - diagnosis</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - etiology</subject><subject>Prognosis</subject><subject>Radiation</subject><subject>Radiation Injuries - diagnosis</subject><subject>Radiation Injuries - epidemiology</subject><subject>Radiation Injuries - etiology</subject><subject>radiation papillopathy</subject><subject>radiation retinopathy</subject><subject>Radiosurgery</subject><subject>Radiosurgery - adverse effects</subject><subject>Radiosurgery - instrumentation</subject><subject>radio‐induced complications</subject><subject>Regression analysis</subject><subject>Retinopathy</subject><subject>Retrospective Studies</subject><subject>Risk factors</subject><subject>Time Factors</subject><subject>Tumors</subject><subject>uveal melanoma</subject><subject>Uveal Neoplasms - radiotherapy</subject><subject>Visual Acuity</subject><issn>1755-375X</issn><issn>1755-3768</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kEtKBDEQQIMo_hdeQAKuXIx2uvObpYg_EBRUcNfUJJUh2t0Zk-mR2XkEz-hJjLa6M5vK4vGKeoTsseKI5XcMIR0xrhlfIZtMCTGqlNSrf3_xuEG2UnoqCsmk5Otko6pkpUulNsniNqL1Zu4XSB2YeYiJBkcjWB8-3t59Z3uDlprQzhpvYO5Dl6jvKBtziktMtO8sxmnw3ZROoW2BPnfe4SBIfZxiXFIXIu0XCA1tsYEutLBD1hw0CXd_5jZ5OD-7P70cXd9cXJ2eXI9MpTUfWScBtJNS6XyKFRNAzhVjiCXXmk2stUUlqrHiUEohQLnMGQBm7KREJ6ttcjB4ZzG89Jjm9VPoY5dX1qUYq5yhUCJThwNlYkgpoqtn0bcQlzUr6q_CdS5cfxfO7P6PsZ-0aP_I36QZOB6AV9_g8n9TfXJzNyg_AU_Vh-o</recordid><startdate>202112</startdate><enddate>202112</enddate><creator>Cicinelli, Maria Vittoria</creator><creator>Di Nicola, Maura</creator><creator>Gigliotti, Carmen Rosaria</creator><creator>Battista, Marco</creator><creator>Miserocchi, Elisabetta</creator><creator>Vecchio, Antonella</creator><creator>Mortini, Pietro</creator><creator>Bandello, Francesco</creator><creator>Modorati, Giulio Maria</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><orcidid>https://orcid.org/0000-0001-5940-6177</orcidid><orcidid>https://orcid.org/0000-0003-3238-9682</orcidid><orcidid>https://orcid.org/0000-0003-2938-0409</orcidid></search><sort><creationdate>202112</creationdate><title>Predictive factors of radio‐induced complications in 194 eyes undergoing gamma knife radiosurgery for uveal melanoma</title><author>Cicinelli, Maria Vittoria ; Di Nicola, Maura ; Gigliotti, Carmen Rosaria ; Battista, Marco ; Miserocchi, Elisabetta ; Vecchio, Antonella ; Mortini, Pietro ; Bandello, Francesco ; Modorati, Giulio Maria</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3884-df6aa8f6678755d5bae44711ee24881bddd0353974a2655a7f875caa1cdb2ef63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>choroidal melanoma</topic><topic>Eye</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>gamma knife radiosurgery</topic><topic>Glaucoma</topic><topic>Humans</topic><topic>Italy - epidemiology</topic><topic>Male</topic><topic>Melanoma</topic><topic>Melanoma - radiotherapy</topic><topic>Middle Aged</topic><topic>neovascular glaucoma</topic><topic>Patients</topic><topic>Postoperative Complications - diagnosis</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - etiology</topic><topic>Prognosis</topic><topic>Radiation</topic><topic>Radiation Injuries - diagnosis</topic><topic>Radiation Injuries - epidemiology</topic><topic>Radiation Injuries - etiology</topic><topic>radiation papillopathy</topic><topic>radiation retinopathy</topic><topic>Radiosurgery</topic><topic>Radiosurgery - adverse effects</topic><topic>Radiosurgery - instrumentation</topic><topic>radio‐induced complications</topic><topic>Regression analysis</topic><topic>Retinopathy</topic><topic>Retrospective Studies</topic><topic>Risk factors</topic><topic>Time Factors</topic><topic>Tumors</topic><topic>uveal melanoma</topic><topic>Uveal Neoplasms - radiotherapy</topic><topic>Visual Acuity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cicinelli, Maria Vittoria</creatorcontrib><creatorcontrib>Di Nicola, Maura</creatorcontrib><creatorcontrib>Gigliotti, Carmen Rosaria</creatorcontrib><creatorcontrib>Battista, Marco</creatorcontrib><creatorcontrib>Miserocchi, Elisabetta</creatorcontrib><creatorcontrib>Vecchio, Antonella</creatorcontrib><creatorcontrib>Mortini, Pietro</creatorcontrib><creatorcontrib>Bandello, Francesco</creatorcontrib><creatorcontrib>Modorati, Giulio Maria</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><jtitle>Acta ophthalmologica (Oxford, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cicinelli, Maria Vittoria</au><au>Di Nicola, Maura</au><au>Gigliotti, Carmen Rosaria</au><au>Battista, Marco</au><au>Miserocchi, Elisabetta</au><au>Vecchio, Antonella</au><au>Mortini, Pietro</au><au>Bandello, Francesco</au><au>Modorati, Giulio Maria</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictive factors of radio‐induced complications in 194 eyes undergoing gamma knife radiosurgery for uveal melanoma</atitle><jtitle>Acta ophthalmologica (Oxford, England)</jtitle><addtitle>Acta Ophthalmol</addtitle><date>2021-12</date><risdate>2021</risdate><volume>99</volume><issue>8</issue><spage>e1458</spage><epage>e1466</epage><pages>e1458-e1466</pages><issn>1755-375X</issn><eissn>1755-3768</eissn><abstract>Background and purpose
To report the factors predictive of radio‐induced complications (i.e. radiation retinopathy [RR], radiation papillopathy [RP] and neovascular glaucoma [NVG]) in uveal melanoma (UM) patients undergoing gamma knife radiosurgery (GKR).
Materials and methods
Longitudinal cohort study on patients with UM treated at the Ocular Oncology Service, San Raffaele Scientific Institute, Milan, between June 1994 and November 2018. Data were retrospectively reviewed. Rates of GKR‐related complications were reported. Variables associated with each complication were investigated using multivariable Cox models and confirmed by logistic regression analysis. Hazard ratio (HR) and 95% confidence intervals (CI) were reported for significant associations.
Results
One hundred ninety‐four patients (99 males, 51%) were included, and 184 tumours were primarily located in the choroid (95%). Median follow‐up was 57 months (range 6–286). Local control was achieved in 182 eyes (94%), and 152 eyes (78%) experienced at least one radiation‐induced complication. Radiation retinopathy was documented in 67 eyes (35%) after a median of 23 months. Older age (HR = 0.97, 95% CI = 0.95–0.99, p = 0.02) had a protective effect for RR. Radiation papillopathy was diagnosed in 35 eyes (18%) after a median of 14 months after GKR. Macular or peripapillary location (HR = 3.06, 95% CI = 1.52–6.16, p = 0.002) was associated with increased risk of RP, while older age was protective (HR = 0.95, 95% CI = 0.93–0.98, p = 0.001). New‐onset NVG was found in 53 eyes (27%), and median onset was 28 months. Tumour thickness (HR = 4.41, 95% CI = 2.23–8.72, p < 0.001) and peripapillary location (HR = 2.78, 95% CI = 1.46–5.27, p = 0.002) were the main risk factors associated with NVG.
Conclusion
Understanding factors predictive for radiation‐related complications in patients undergoing GKR might help for better counselling and treatment planning.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>33638277</pmid><doi>10.1111/aos.14814</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-5940-6177</orcidid><orcidid>https://orcid.org/0000-0003-3238-9682</orcidid><orcidid>https://orcid.org/0000-0003-2938-0409</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Aged, 80 and over choroidal melanoma Eye Female Follow-Up Studies gamma knife radiosurgery Glaucoma Humans Italy - epidemiology Male Melanoma Melanoma - radiotherapy Middle Aged neovascular glaucoma Patients Postoperative Complications - diagnosis Postoperative Complications - epidemiology Postoperative Complications - etiology Prognosis Radiation Radiation Injuries - diagnosis Radiation Injuries - epidemiology Radiation Injuries - etiology radiation papillopathy radiation retinopathy Radiosurgery Radiosurgery - adverse effects Radiosurgery - instrumentation radio‐induced complications Regression analysis Retinopathy Retrospective Studies Risk factors Time Factors Tumors uveal melanoma Uveal Neoplasms - radiotherapy Visual Acuity |
| title | Predictive factors of radio‐induced complications in 194 eyes undergoing gamma knife radiosurgery for uveal melanoma |
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