Radiation therapy in primary orbital lymphoma: a single institution retrospective analysis

Abstract

BackgroundPrimary orbital lymphoma is a rare disease that accounts for 10% of all orbital tumors. Radiotherapy on the orbital cavity is the treatment of choice for this unusual presentation of localized non-Hodgkin's lymphoma (NHL). The aim of this study is to retrospectively evaluate the effectiveness and the toxicity of radiation treatment in patients with primary orbital lymphoma.MethodsForty-seven consecutive patients having primary orbital lymphoma treated in our department between May 1983 and September 2006 were investigated in a retrospective study. Either 60Co γ rays or 6 MV X rays were used to deliver daily fractions of 1.8 or 2.0 Gy, 5 times/week, with total doses ranging from 34.2 to 50 Gy. Forty-three patients had stage IE, three had stage II and one stage IV disease. Thirty-eight patients had marginal zone B-cell lymphoma, 5 diffuse large B cell lymphoma, 3 mantle cell lymphoma and 1 Burkitt lymphoma. Local control (LC), disease free survival (DFS), overall survival (OS) and late side effects were evaluated in all patients.ResultsWith a median follow up of 45 months, LC was obtained in 100% of patients. The estimated 5- and 7-year DFS rates were 75.8% and 55.3%, and the 5- and 7-year OS rates were 88.7% and 79.9% respectively. Acute toxicity was minimal. Late toxicity such as cataract, keratitis, retinopathy and xerophthalmia occurred respectively in 12 (25.5%), 5 (10.6%), 1 (2.1%), and 9 (19.1%) patients.ConclusionRadiotherapy is an effective and at the same time well tolerated treatment for primary orbital lymphoma.

Long-term outcomes of first-line treatment with doxycycline in patients with previously untreated ocular adnexal marginal zone B cell lymphoma

“…However, radiation to the involved eye can result in complications, including cataract (30-50 %), xerophthalmia (20-40 %), and retinopathy (2 %) [1,11,12]. Other options, such as single-agent chemotherapy, immunotherapy with monoclonal anti-CD20 antibody, and antibiotic therapy, have been studied in OAL [1,13].…”

Extranodal Marginal Zone Lymphoma of Ocular Adnexa: Outcomes following Radiation Therapy

“…Long-term survival and excellent local control have been documented with radiotherapy alone [4,9,10,14,15]. It is estimated that using low to moderate radiotherapy doses (25-36 Gy) can obtain 95-100% of local control [4,11,17]. Few authors have advocated radiotherapy doses of 25 Gy or less [16,18,19].…”

“…EMZL is the most frequent, low-grade, indolent, small B-cell lymphoma with a prolonged course of the ocular adnexa [9,10]. Ocular adnexal lymphomas (OAL) of the EMZL type have a high response rate to various treatment modalities, such as radiation therapy, chemotherapy, and immunotherapy [2,9,10,11,12,13]. …”

Orbital lymphomas: Clinical and radiological features

“…They are slowly growing orbital masses that can be asymptomatic or associated with proptosis, periorbital swelling, ocular dysmotility, and blurring of vision (De Cicco et al, 2009).…”