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Table 1 Optic toxicity after 2D RT for sinonasal malignancies

From: Intensity modulated radiotherapy for sinonasal malignancies with a focus on optic pathway preservation

Ref.

#

Median follow up (mo)

Stage

RT

Presciption dose

Local control

Dose to the optic pathway

Vision impairment

Blindness

Ogawa [3]†§

41

93

T4: 31.7%

2D

54 Gy/27 frxǂ (40–70 Gy)

59%

54 & 60 Gy*

7.3%

None

Tiwari [4]†

50

n/a

IV: 50%

2D

64–70 Gy/32–35 frx ± brachytherapy to 82 Gy¶

62%; 16/19 recurrences are stage III or IV

n/a

16% optic retinopathy & neuropathy

2% unilateral blindness

Jiang [5]§

219

n/a

n/a

2D

n/a

n/a

Retina: 58.3 Gy/29 frxǂ.

Ipsilateral: 33.7%.

8.2% ipsilateral blindness due to optic neuropathy; bilateral blindness due to chiasm injury at 10 yrs:

ON: 61.6 Gy/30 frxǂ;

Retinopathy: 20% when 50–60 Gy received;

50–60 Gy: 8%;

OC: 57.1 Gy/30 frxǂ

Optic neuropathy: 2.3% when optic nerve received 44–60 Gy (56 Gy); 34% when optic nerve received 61–78 Gy at 10 yrs

61–76 Gy: 24%.

Logue [6]§

152

61

T4: 44%

2D

45-55 Gy/15–16 frx

45.4%

n/a

n/a

9.9% unilateral blindness, 2.0% bilateral blindness.

Sakai [7]§

171

~ 60

n/a

2D

50-70 Gy/25–35 frx

n/a

n/a

Ipsilateral: 74.6%

Ipsilateral: 63.7%

Contralateral: 36.8%

Contralateral: 2.9%

Olmi [8]

69

n/a

T3-4: 88.4%

2D

42-72 Gy, 2 Gy daily or bid delivered with Co-60 or electrons

56%

n/a

n/a

13.6% (3/22) blindness (60 Gy/30 frx and 52 Gy/26 bid frx)

Nakissa [9]

30

n/a

n/a

2D

34-86 Gy, various fractionation

n/a

n/a

6.7% (after 65 Gy received)

6.7% who received > 68 Gy

  1. # number of patients, n/a not available, frx fraction, †postoperative only, *associated with vision impairment or blindness, ON optic nerve, OC optic chiasm, ǂ median dose, ¶ average dose, pt patient, chemotherapy in a portion of pts§.