This study evaluated the clinical features and treatment outcome of 15 patients with primary intraocular lymphoma. There were nine females, with a median age of 68 years. Thirteen patients presented with bilateral lesions and median time from the onset of symptoms to diagnosis was 12 months. All but one showed the B-cell phenotype. All patients received radiation therapy (RT) with a median of 41 Gy and 10 were administered chemotherapy as well. Three patients were treated with high-dose methotrexate and nine received prophylactic cranial irradiation (PCI) with a median of 30.6 Gy. Thirteen patients obtained a complete remission. The 2-year overall and disease free survival were 74% and 58%, respectively. Although only one patient experienced local recurrence, PCI did not prevent intracranial recurrence. One patient developed a grade 3 cognitive disturbance. It was concluded that ocular RT was effective to control primary lesions. However, some modifications are indispensable to improve outcomes.
Three cases of advanced maxillary sinus cancer with orbital invasion were treated with intra-arterial (IA) chemoradiation therapy including internal carotid arterial infusion to preserve ocular function. One case needed total maxillectomy with exenteration and two cases were inoperable. Two cases received alternating chemoradiotherapy with two courses of intra-venous chemotherapy (TPF ; taxotere, cisplatin, 5FU) . IA infusion of CDDP (35-50mg/m 2 /week) was administered through the microcatheter from the external carotid arterial sheath (ECAS) inserted into the superficial temporal artery. Total CDDP dose was 175-400mg/m 2 , and total CDDP dose to the internal carotid artery was 80-115mg/body. Intensity modulated radiation therapy (IMRT) was applied to three cases without exceeding the maximum dose to the optic nerve of more than 60Gy. Although the follow-up period was short, local control within the orbita and ocular functions were preserved in three cases. IA chemoradiation therapy including internal carotid arterial infusion might be useful to preserve ocular function.
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