Dose-Response and Normal Tissue Complication Probabilities after Proton Therapy for Choroidal Melanoma

PurposeNormal tissue complication probability (NTCP) models could aid the understanding of dose dependence radiation-induced toxicities after eye-preserving radiotherapy choroidal melanomas. We performed NTCP-modeling and established dose-response relationships for visual acuity (VA) deterioration common late complications treatments with proton therapy (PT).DesignRetrospective study from single, large referral center.ParticipantsWe considered patients Nice, France, diagnosed melanoma treated primarily hypofractionated PT (52 Gy physical in 4 fractions). Complete VA information was available 1020 patients, complete on 991 patients.MethodsTreatment details, dose-volume histograms (DVHs) relevant anatomic structures, patient tumor characteristics were a dedicated ocular database. Least absolute shrinkage selection operator (LASSO) variable used to identify variables strongest impact each end point, followed by multivariate Cox regressions logistic analyze among dose, clinical characteristics, outcomes.Main Outcome MeasuresDose-response relationship complications.ResultsDose metrics several structures (i.e., optic disc, macula, retina, globe, lens, ciliary body) correlated outcome. The near-maximum macula showed correlation deterioration. retina only clear risk maculopathy, 20% disc had largest neuropathy, cornea neovascular glaucoma, body hypertension. volume receiving 26 associated cataract, 52 retinal detachment. Optic disc-to-tumor distance dry eye syndrome absence DVH lachrymal gland.ConclusionsVA specific demonstrated delivered normal melanoma. depended range whereas more related structures. Normal (PT). Retrospective center. patients. Treatment outcomes. Dose-response complications. Dose gland.