Orbital and conjunctival lymphoma treatment and prognosis

Bessell, E.M.; Henk, J.M.; Wright, J E; Whitelocke, R.A.F.

doi:10.1016/0167-8140(88)90218-6

Cited by 103 publications

(65 citation statements)

References 22 publications

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“…[1][2][3][4] Likewise, outcome is related to clinical stage at presentation, patients with disseminated disease (stage IVE) having a worse prognosis than localised disease (stage IE). [1][2][3] Prognosis is also related to the primary location of the adnexal disease, 2,5 eyelid lymphomas having a more aggressive course than orbital or conjunctival disease [2][3][4] conjunctival lymphomas having a good prognosis, and patients with conjunctival and deep orbital disease having similar survival. [4][5][6][7][8][9] Although not observed in larger studies, 2,4,8 a recent small series suggested that lacrimal gland lymphoma presents a greater risk of subsequent systemic disease than orbital disease.…”

Section: Introductionmentioning

confidence: 99%

“…10 Survival after unilateral or bilateral adnexal disease is similar, 2,4,[8][9][10] and there may be an association between bilateral orbital disease and systemic involvement at diagnosis. 3 Other clinical features (such as symptom duration, inflammatory symptoms and signs, proptosis, visual function or eye movements) have not been examined in these relatively limited series, the largest having reviewed 112 patients. 3 We have analysed the presenting symptoms and signs of 369 patients with adnexal lymphoma, relating these to the extent of disease at presentation and long-term outcome.…”

Section: Introductionmentioning

confidence: 99%

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Clinical features associated with survival of patients with lymphoma of the ocular adnexa

Jenkins

Rose

Bunce

et al. 2003

Eye

100

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Purpose Although systemic or eyelid involvement by ocular adnexal lymphoma carries a worse prognosis, there have been few reports of the outcome in relation to clinical presentation. The outcome of malignant ocular adnexal lymphoma was, therefore, related to presenting clinical symptoms and signs. Design and Methods A retrospective, noncomparative case-note review of 326 patients treated in the Orbital Clinic at Moorfields Eye Hospital. The associations between presenting symptoms or signs and three outcome measures (v.i.) were assessed by univariate and multiple variable regression together with Kaplan-Meier analysis. Main Outcome Measures (i) Presence of extraorbital disease at the time of presentation; (ii) development of systemic lymphoma after new presentation with solely ocular adnexal disease; and (iii) death attributable to widespread lymphoma. Results Presentation with disseminated disease was rarer with over 1 year's ophthalmic symptoms (odds ratio (OR) 0.7; 95% CI 0.5-0.9) and much more frequent with bilateral adnexal disease (OR 5.8; 95% CI 3.0-11.2). With solely adnexal disease at presentation, subsequent extra-orbital lymphoma was more frequent and earlier with lacrimal gland disease (as compared to those without; hazard ratio (HR) 1.9; 95% CI 1.2-4.5) or with eyelid disease (compared to those without; HR 2.4; 95% CI 1.2-4.5), or with bilateral disease (compared to unilateral disease; HR 2.6; 95% CI 1.4-5.2). Prior or concurrent systemic disease was the most significant predictive factor for lymphoma-related death (HR 6.8;), but tumour-related death was also commoner and earlier with bilateral disease (HR 2.4; 95% CI 1.4-4.0) or where a relative afferent papillary defect was present (HR 2.8; 95% CI 1.6-4.9). Similarly, the rate of tumourrelated death was slightly less where symptoms had been present for more than a year (HR 0.8; 95% CI 0.7-1.0) and slightly greater in the elderly (HR 1.03; 95% CI 1.01-1.05). Conjunctival lymphoma had the lowest rate of extra-orbital spread and lymphoma-related death, the rate of these two events being sequentially greater for patients with predominantly deep orbital lymphoma, lacrimal gland lymphoma, or eyelid lymphoma. Conclusion These data suggest that presenting symptoms and signs of patients with ocular adnexal lymphoma are significantly associated with the risk of systemic disease at orbital presentation, the rate of subsequent spread, and the rate of lymphoma-related death.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical features associated with survival of patients with lymphoma of the ocular adnexa

Jenkins

Rose

Bunce

et al. 2003

Eye

100

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“…Some recommend 24 Gy to 35 Gy, since higher doses d o not improve therapeutic results but yield only greater side effects (96,97). Others recommend 30 Gy to 35 Gy for low-grade malignant NHL and 36 Gy to 40 Gy for high-grade malignant NHL (94,95). Lens shields should be uscd to reduce the risk for cataracts.…”

Section: Orbital Lymphornumentioning

confidence: 99%

“…while only 25% of patients with high-grade malignant orbital lymphoma were alive after 10 years. All mortality was a result of generalized lymphoma (95).…”

Section: Orbital Lymphornumentioning

confidence: 99%

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Non-Hodgkin's Lymphomas (NHL)

Gustafsson

1996

Acta Oncologica

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Summary and ConclusionsThis synthesis of the literature on radiotherapy for non-Hodgkin's lymphomas is based on 158 scientific articles, including 16 randomized studies, 18 prospective studies, and 90 retrospective studies. These studies involve I4 137 patients.-Non-Hodgkin's lymphomas are highly radiosensitive, and local recurrence following radiotherapy is unusual.-Radiotherapy probably cures approximately ~O"/U of both low-grade and high-grade malignant NHL at stage 1. Involved field is apparently sufficient, however, higher doses are required for high-grade malignant lymphomas.

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