Observational studyInternational journal of radiation oncology, biology, physics2019
Prospective Assessment of Patient-Reported Dry Eye Syndrome After Whole Brain Radiation.
Observational study in International journal of radiation oncology, biology, physics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- Consensus radiation therapy organ at risk constraints for NCTN trials in hematologic malignancies.Journal of the National Cancer Institute · 2026Article
- Isocenter Optimization in WBRT: Concurrent Sparing of Lens and Lacrimal Gland via Anterior Penumbra Sharpening.Journal of applied clinical medical physics · 2026Article
- NTCP model guided whole brain radiation re-planning to reduce risk of acute xerostomia and dry eye.Journal of applied clinical medical physics · 2025Article
- The Effects of Radiation Therapy on the Ocular Apparatus: Implications for Management.Cancers · 2025Review
- Dosimetric analysis of different whole brain radiotherapy treatment planning methods: three types of 3-dimensional versus hippocampal avoidant.Radiation oncology journal · 2025Article
- A deep dive into radiation keratopathy; Going beyond the current frontierss.Experimental eye research · 2025Article
- Progress in radiotherapy for small-cell lung cancer.Precision radiation oncology · 2023Review
- Mask dependency of the lacrimal gland dose under whole brain radiotherapy when the six-degrees of freedom couch is not available.Journal of applied clinical medical physics · 2023Article
- Ocular Surface Changes in Treatment-Naive Thyroid Eye Disease.Journal of clinical medicine · 2023Article
- OSDI Questions on Daily Life Activities Allow to Detect Subclinical Dry Eye in Young Contact Lens Users.Journal of clinical medicine · 2022Article
- Hybrid split-arc partial-field volumetric modulated arc therapy: an improved beam arrangement for linear accelerator-based hippocampal-avoidance whole brain radiation therapy.Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology · 2022Article
- NTCP modeling and dose-volume correlations for acute xerostomia and dry eye after whole brain radiation.Radiation oncology (London, England) · 2021Observational
- Volumetric modulated arc therapy (VMAT) for hippocampal-avoidance whole brain radiation therapy: planning comparison with Dual-arc and Split-arc partial-field techniques.Radiation oncology (London, England) · 2020Article
- Alpha-Lipoic Acid Ameliorates Radiation-Induced Lacrimal Gland Injury through NFAT5-Dependent Signaling.International journal of molecular sciences · 2019Article
- Multidisciplinary patient-centered management of brain metastases and future directions.Neuro-oncology advancesReview
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Authors and funding
18 authors.
Funding
Abstract
purposeDry eye is not typically considered a toxicity of whole brain radiation therapy (WBRT). We analyzed dry eye syndrome as part of a prospective study of patient-reported outcomes after WBRT. METHODS AND MATERIALS: Patients receiving WBRT to 25 to 40 Gy were enrolled on a study with dry mouth as the primary endpoint and dry eye syndrome as a secondary endpoint. Patients received 3-dimensional WBRT using opposed lateral fields. Per standard practice, lacrimal glands were not prospectively delineated. Patients completed the Subjective Evaluation of Symptom of Dryness (SESoD, scored 0-4, with higher scores representing worse dry eye symptoms) at baseline, immediately after WBRT (EndRT), and at 1 month (1M), 3 months, and 6 months. Patients with baseline SESoD ≥3 (moderate dry eye) were excluded. The endpoints analyzed were ≥1-point and ≥2-point increase in SESoD score at 1M. Lacrimal glands were retrospectively delineated with fused magnetic resonance imaging scans.
resultsOne hundred patients were enrolled, 70 were eligible for analysis, and 54 were evaluable at 1M. Median bilateral lacrimal V20Gy was 79%. At 1M, 17 patients (32%) had a ≥1-point increase in SESoD score, and 13 (24%) a ≥2-point increase. Lacrimal doses appeared to be associated with an increase in SESoD score of both ≥1 point (V10Gy: P = .042, odds ratio [OR] 1.09/%; V20Gy: P = .071, OR 1.03/%) and ≥2 points (V10Gy: P = .038, OR 1.15/%; V20Gy: P = .063, OR 1.04/%). The proportion with increase in dry eye symptoms at 1M for lacrimal V20Gy ≥79% versus <79% was 46% versus 15%, respectively, for ≥1 point SESoD increase (P = .02) and 36% versus 12%, respectively, for ≥2 point SESoD increase (P = .056).
conclusionsDry eye appears to be a relatively common, dose/volume-dependent acute toxicity of WBRT. Minimization of lacrimal gland dose may reduce this toxicity, and patients should be counseled regarding the existence of this potential side effect and treatments for dry eye.
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