Ressortforschungsberichte zur kerntechnischen Sicherheit und zum ...

Reference:
First author (year)
Type of ionising
radiation applied
in irradiated
group
Gragoudas et al., 1995 Proton irradiation
(external beam)
Meecham et al., 1994 Helium ion
irradation (tantalum
marker rings)
Kleineidam et al., 1993 Cobalt-60 plaque
radiotherapy
Henk et al., 1993 Megavoltage
irradiation
Bessel et al., 1987 Cobalt beam
therapy or
superficial X-rays
Packer et al., 2003 Type of radiation
therapy not further
specified
Radiation dose regimen or
reconstructed total body
dose (TBD)
70 Cobalt Gray equivalent
(CGE) fractionated over 8 day
Tumour doses between 48-80
Gy equivalents
Basal radiation dose from
171.0 Gy to 702.0 Gy, apical
radiation dose 26.3 Gy to
157.0 Gy
Tumour doses between 20-40
Gy, fractions of 1.9-2 Gy 5
times per week
In most patients 30 Gy in 15
fractions over 3 weeks, some
40 Gy in 20 fractions over 4
weeks.
Max. radiation dose in each of
four anatomic segments:
< 30, 30-49, and >=50 Gy
Lens dose (LD) Exposure assessment Outcome assessment
LD reconstruction for each
patient; LD at least 50% of
the total radiation dose
LD reconstruction for each
patient; grouped for analysis
LD and dose rate to the lens
estimated from twodimensional
isodose
distributions.
LD in the range 4.5-30 Gy
in 10-20 fractions
Mean LD 15 Gy in shielded
lenses.
Not stated Segment-specific dosimetry
from medical records on
diagnosis and treatment
– 118 –
Risk estimates for cataract
Estimated cumulative
incidence (ECI),
or other results of
incidence
Medical records Ophthalmic examination Posterior subcapsular
opacities (PSC) in
42% by 3 years.
Medical records Ophthalmic examination By 7 years, cataracts
in >90% of patients
with more than half of
the lens in the beam.
Medical records Ophthalmic examination;
cataract definition given
in the paper, no grading
system used.
In patients with 6-20
Gy at the center of
lens 5-year (10 year)
ECI of cataract was
22% (57%), with 20 to
< 40 Gy 72% (93%),
with ≥ 40 Gy 81%
(100%).
Medical records Ophthalmic examination ECI for opacities in 22
patients with a mean
dose to the germinative
zone of 15 Gy
57% at 8 years.
Medical records Slit- lamp biomicroscopy ECI for opacities at 5
years 64% in
unshielded lenses vs.
12% in shielded
lenses.
Questionnaires (selfreported)
3% of patients
reported cataracts.
Comparative
analyses; risk ratio
(RR), or hazard
rate (HR)
RR=3.25 (95%CI:
1.60-6.59) for PSC,
if doses to the lens
was high compared
to low, and
RR=3.05 (1.45-
6.4), if tumour
height >6.5 mm.
Cataract development
was a function
of the percentage of
lens in the beam.
-
No opacities after
3-9 years after
doses of ≤ 5 Gy,
always with ≥ 16.5
Gy; with a max. LD
of 15 Gy opacities
in 57% at 8 years
follow-up.
-
RR=11.9 (p=<
0.0001) for cataract
in cases compared
to controls.