Evaluation of the prevalence and severity of xerophthalmia in head and neck cancers patients undergoing curative radiotherapy
Background: The study objective was to assess the development of xerophthalmia [dry eye syndrome (DES) or keratoconjunctivitis sicca] in head and neck cancer patients undergoing radiotherapy.
Methods: Twenty two head and neck cancer patients requiring more than 60 Gy of curative radiotherapy/chemoradiotherapy and ten patients requiring radiotherapy/ chemoradiotherapy for treating cancers in the non head and neck regions (like breast, oesophagus, prostate, cervix and rectal cancers) were also enrolled in the study. The development of DES was studied at the beginning (day 0, before the start of radiotherapy) at day 21 (after completion of 30 Gy) and on completion of the treatment (> 60 Gy). As a comparative cohort, people with non head and neck cancer needing curative radiotherapy were also evaluated for comparison.
Results: There was no difference in degree of DES between the Head and Neck cancer cohorts and non head and neck group at the beginning of treatment. However there was a statistically significant difference (p < 0.001) between the two groups at both mid and end of RT time point. Inter comparison between the various time points in the head and neck cancer group showed that the incidence of DES increased with the radiation exposure and was significant (pre to mid p < 0.001; and mid to end p < 0.005). A negative (r = -0.262) correlation was seen between DES and distance.
Conclusions: The study showed that lesser the distance from the epicenter of the radiation to the orbital rim more was the severity of DES.