Assessment of Radiation-Induced Optic Neuropathy in a Multi-Institutional Cohort of Chordoma and Chondrosarcoma Patients Treated with Proton Therapy

Radiation-induced optic neuropathy (RION) is a rare side effect following radiation therapy involving the optic structures whose onset is, due to the low amount of available data, challenging to predict. We have analyzed a multi-institutional cohort including 289 skull-base cancer patients treated w...

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Autores principales:	Andreas Köthe, Loïc Feuvret, Damien Charles Weber, Sairos Safai, Antony John Lomax, Giovanni Fattori
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	proton therapy RION NTCP optic toxicity skull base chordoma Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/b6b30a81a82f44af96b2f7c5f7b98f6a
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spelling	oai:doaj.org-article:b6b30a81a82f44af96b2f7c5f7b98f6a2021-11-11T15:28:22ZAssessment of Radiation-Induced Optic Neuropathy in a Multi-Institutional Cohort of Chordoma and Chondrosarcoma Patients Treated with Proton Therapy10.3390/cancers132153272072-6694https://doaj.org/article/b6b30a81a82f44af96b2f7c5f7b98f6a2021-10-01T00:00:00Zhttps://www.mdpi.com/2072-6694/13/21/5327https://doaj.org/toc/2072-6694Radiation-induced optic neuropathy (RION) is a rare side effect following radiation therapy involving the optic structures whose onset is, due to the low amount of available data, challenging to predict. We have analyzed a multi-institutional cohort including 289 skull-base cancer patients treated with proton therapy who all received >45 Gy<sub>RBE</sub> to the optic apparatus. An overall incidence rate of 4.2% (12) was observed, with chordoma patients being at higher risk (5.8%) than chondrosarcoma patients (3.2%). Older age and arterial hypertension, tumor involvement, and repeated surgeries (>3) were found to be associated with RION. Based on bootstrapping and cross-validation, a NTCP model based on age and hypertension was determined to be the most robust, showing good classification ability (AUC-ROC 0.77) and calibration on our dataset. We suggest the application of this model with a threshold of 6% to segment patients into low and high-risk groups before treatment planning. However, further data and external validation are warranted before clinical application.Andreas KötheLoïc FeuvretDamien Charles WeberSairos SafaiAntony John LomaxGiovanni FattoriMDPI AGarticleproton therapyRIONNTCPoptic toxicityskull basechordomaNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancers, Vol 13, Iss 5327, p 5327 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	proton therapy RION NTCP optic toxicity skull base chordoma Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	proton therapy RION NTCP optic toxicity skull base chordoma Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Andreas Köthe Loïc Feuvret Damien Charles Weber Sairos Safai Antony John Lomax Giovanni Fattori Assessment of Radiation-Induced Optic Neuropathy in a Multi-Institutional Cohort of Chordoma and Chondrosarcoma Patients Treated with Proton Therapy
description	Radiation-induced optic neuropathy (RION) is a rare side effect following radiation therapy involving the optic structures whose onset is, due to the low amount of available data, challenging to predict. We have analyzed a multi-institutional cohort including 289 skull-base cancer patients treated with proton therapy who all received >45 Gy<sub>RBE</sub> to the optic apparatus. An overall incidence rate of 4.2% (12) was observed, with chordoma patients being at higher risk (5.8%) than chondrosarcoma patients (3.2%). Older age and arterial hypertension, tumor involvement, and repeated surgeries (>3) were found to be associated with RION. Based on bootstrapping and cross-validation, a NTCP model based on age and hypertension was determined to be the most robust, showing good classification ability (AUC-ROC 0.77) and calibration on our dataset. We suggest the application of this model with a threshold of 6% to segment patients into low and high-risk groups before treatment planning. However, further data and external validation are warranted before clinical application.
format	article
author	Andreas Köthe Loïc Feuvret Damien Charles Weber Sairos Safai Antony John Lomax Giovanni Fattori
author_facet	Andreas Köthe Loïc Feuvret Damien Charles Weber Sairos Safai Antony John Lomax Giovanni Fattori
author_sort	Andreas Köthe
title	Assessment of Radiation-Induced Optic Neuropathy in a Multi-Institutional Cohort of Chordoma and Chondrosarcoma Patients Treated with Proton Therapy
title_short	Assessment of Radiation-Induced Optic Neuropathy in a Multi-Institutional Cohort of Chordoma and Chondrosarcoma Patients Treated with Proton Therapy
title_full	Assessment of Radiation-Induced Optic Neuropathy in a Multi-Institutional Cohort of Chordoma and Chondrosarcoma Patients Treated with Proton Therapy
title_fullStr	Assessment of Radiation-Induced Optic Neuropathy in a Multi-Institutional Cohort of Chordoma and Chondrosarcoma Patients Treated with Proton Therapy
title_full_unstemmed	Assessment of Radiation-Induced Optic Neuropathy in a Multi-Institutional Cohort of Chordoma and Chondrosarcoma Patients Treated with Proton Therapy
title_sort	assessment of radiation-induced optic neuropathy in a multi-institutional cohort of chordoma and chondrosarcoma patients treated with proton therapy
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/b6b30a81a82f44af96b2f7c5f7b98f6a
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Assessment of Radiation-Induced Optic Neuropathy in a Multi-Institutional Cohort of Chordoma and Chondrosarcoma Patients Treated with Proton Therapy

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