{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T09:58:45Z","timestamp":1792403925614,"version":"4.4.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"1107","license":[{"start":{"date-parts":[[2019,8,1]],"date-time":"2019-08-01T00:00:00Z","timestamp":1564617600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,3,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objective:<\/jats:title>\n                  <jats:p>To assess the radiation-induced optic neuropathy (RION) prevalence, following high dose pencil beam scanning proton therapy (PBSPT) to skull base and head and neck (H&amp;N) tumours<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods:<\/jats:title>\n                  <jats:p>Between 1999 and 2014, 216 adult patients, median age 47 years (range, 18\u201377), were treated with PBS PT for skull base or H&amp;N malignancies, delivering \u226545 GyRBE to the optic nerve(s) (ON) and\/or optic chiasma (OC). The median administered dose to the planning target volume was 74.0 GyRBE (range, 54.0\u201377.4). The median follow-up was 5.3 years (range, 0.8\u201315.9).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results:<\/jats:title>\n                  <jats:p>RION was observed in 14 (6.5%) patients at a median time of 13.2 months (range, 4.8\u201342.6) following PBSPT. Most (92.9%) of RION were symptomatic. Most affected patients (11\/14; 79%) developed unilateral toxicity. Grade 4, 3, 2 and 1 toxicity was observed in 10, 2, 1 and 1 patients, respectively. On univariate analyses, age (&amp;lt;70\u2009vs \u226570 years; p &amp;lt; 0.0001), hypertension (\ufeffp = 0.0007) and tumour abutting the optic apparatus (p = 0.012) were associated with RION. OC\u2019s V60 GyRBE was of border line significance (p = 0.06). None of the other evaluated OC\u2013ON dose\/volume metrics (Dmax, Dmean, V40-60) were significantly associated with this complication.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion:<\/jats:title>\n                  <jats:p>These data suggest that high-dose PBS PT for skull base and H&amp;N tumours is associated with a low prevalence of RION. Caution should be however exercised when treating elderly\/hypertensive patients with tumours abutting the optic apparatus.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Advances in knowledge:<\/jats:title>\n                  <jats:p>This is the first study reporting the risk of developing RION following proton therapy with PBS technique, demonstrating the safety of this treatment.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1259\/bjr.20190028","type":"journal-article","created":{"date-parts":[[2019,7,19]],"date-time":"2019-07-19T16:40:33Z","timestamp":1563554433000},"source":"Crossref","is-referenced-by-count":28,"title":["Radiation-induced optic neuropathy after pencil beam scanning proton therapy for skull-base and head and neck tumours"],"prefix":"10.1093","volume":"93","author":[{"given":"Melpomeni","family":"Kountouri","sequence":"first","affiliation":[{"name":"Center for Proton Therapy, Paul Scherrer Institute, ETH Domain, CH-5232 , Villigen , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessia","family":"Pica","sequence":"additional","affiliation":[{"name":"Center for Proton Therapy, Paul Scherrer Institute, ETH Domain, CH-5232 , Villigen , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Walser","sequence":"additional","affiliation":[{"name":"Center for Proton Therapy, Paul Scherrer Institute, ETH Domain, CH-5232 , Villigen , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Albertini","sequence":"additional","affiliation":[{"name":"Center for Proton Therapy, Paul Scherrer Institute, ETH Domain, CH-5232 , Villigen , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Bolsi","sequence":"additional","affiliation":[{"name":"Center for Proton Therapy, Paul Scherrer Institute, ETH Domain, CH-5232 , Villigen , 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