Treatment Effects and Sequelae of Radiation Therapy for Orbital Mucosa-Associated Lymphoid Tissue Lymphoma

Hata, Masaharu; Omura, Motoko; Koike, Izumi; Tomita, Naoto; Iijima, Yasuhito; Tayama, Yoshibumi; Odagiri, Kazumasa; Minagawa, Y.; Ogino, Ichiro; Inoue, Tomio

doi:10.1016/j.ijrobp.2010.07.1992

Cited by 21 publications

(36 citation statements)

References 30 publications

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“…14,25,34,43,44 Similarly, RT achieved local control in 97% of our Ann Arbor stage I POAML patients. However, there is still no consensus on the optimal dose of RT.…”

Section: Discussionmentioning

confidence: 79%

Long-term course of patients with primary ocular adnexal MALT lymphoma: a large single-institution cohort study

Desai

Joag

Lekakis

et al. 2017

Blood

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Key Points• POAML (specifically Ann Arbor stage I disease) has an excellent clinical outcome, with only a few patients succumbing to lymphoma.• POAML patients face a continuous risk of distant relapse, including in the central nervous system, and transformation to aggressive lymphoma.While primary ocular adnexal mucosa-associated lymphoid tissue (MALT) lymphoma (POAML) is the most common orbital tumor, there are large gaps in knowledge of its natural history. We conducted a retrospective analysis of the largest reported cohort, consisting of 182 patients with POAML, diagnosed or treated at our institution to analyze long-term outcome, response to treatment, and incidence and localization of relapse and transformation. The majority of patients (80%) presented with stage I disease. Overall, 84% of treated patients achieved a complete response after first-line therapy. In patients with stage I disease treated with radiation therapy (RT), doses ‡30.6 Gy were associated with a significantly better complete response rate (P 5 .04) and progression-free survival (PFS) at 5 and 10 years (P < .0001). Median overall survival and PFS for all patients were 250 months (95% confidence interval [CI], 222 [upper limit not reached]) and 134 months (95% CI, 87-198), respectively. Kaplan-Meier estimates for the PFS at 1, 5, and 10 years were 91.5% (95% CI, 86.1% to 94.9%), 68.5% (95% CI, 60.4% to 75.6%), and 50.9% (95% CI, 40.5% to 61.6%), respectively. In univariate analysis, age >60 years, radiation dose, bilateral ocular involvement at presentation, and advanced stage were significantly correlated with shorter PFS (P 5 .006, P 5 .0001, P 5 .002, and P 5 .0001, respectively). Multivariate analysis showed that age >60 years (hazard ratio [HR] 2.44) and RT<30.6Gy (HR54.17) were the only factors correlated with shorter PFS (P 5 .01 and P 5 .0003, respectively). We demonstrate that POAMLs harbor a persistent and ongoing risk of relapse, including in the central nervous system, and transformation to aggressive lymphoma (4%), requiring long-term follow-up. (Blood. 2017;129(3):324-332)

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“…14,25,34,43,44 Similarly, RT achieved local control in 97% of our Ann Arbor stage I POAML patients. However, there is still no consensus on the optimal dose of RT.…”

Section: Discussionmentioning

confidence: 79%

Long-term course of patients with primary ocular adnexal MALT lymphoma: a large single-institution cohort study

Desai

Joag

Lekakis

et al. 2017

Blood

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“…Twenty peer-reviewed articles were reviewed from 1997 to 2013 [4,8,12,14,15,16,22,23,24,25,26,27,28,29,30,31,32,33,34,35]. All patients treated with radiation therapy only were recorded.…”

Section: Resultsmentioning

confidence: 99%

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

Platt¹,

Zahrani²,

Singh

et al. 2017

Ocul Oncol Pathol

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Aim: The aim of this study was to report outcomes following radiation therapy in patients with biopsy-proven extranodal marginal zone lymphoma of the ocular adnexa and uvea. Methods: Records from a single institution were retrospectively reviewed from January 1997 to December 2015. The mean follow-up duration was 38 months (range 0-194). Radiation therapy was administered to 77 eyes (60 patients); 57 of the 77 eyes (74%) were treated with radiation only (range 20-36 Gy, median 15 fractions). Radiation cataract, radiation retinopathy, and optic neuropathy assessments were performed on all eyes treated with radiation. Results: 100% of the 47 patients treated with radiation therapy only had local control with an average dose of 26.5 Gy (median 25.2 [range 20-36] Gy; 150-200 cGy per fraction). Four patients lost 2 lines or more of vision after radiation. The most common complication of radiation therapy was cataract formation/progression in 19 eyes (25%). Radiation retinopathy was observed only in 1 patient (1%). Conclusion: Our results confirm that radiation therapy (median 25 Gy) for extranodal marginal zone lymphoma of the ocular adnexa is associated with high local control and low risk of visually significant complications.

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“…[61][62][63] Humans with conjunctival lymphoma typically have nonspecific signs of conjunctivitis such as conjunctival swelling, redness, and irritation [64][65][66] or subsequent development of discrete conjunctival masses, which can extend posteriorly leading to progressive proptosis. 67 Treatment options include surgical resection, combination chemotherapy (vincristine, cyclophosphamide, prednisone, and doxorubicin), single-agent chemotherapy (chlorambucil), [68][69][70] radiation therapy, [70][71][72] immunotherapy, 73,74 or antimicrobials. 75 Median disease-free intervals for humans with conjunctival lymphoma range from 8 to 66 months.…”

Section: Discussionmentioning

confidence: 99%

Presumed solitary intraocular or conjunctival lymphoma in dogs and cats: 9 cases (1985–2013)

Wiggans¹,

Skorupski²,

Reilly³

et al. 2014

javma

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Objective—To determine prevalence, reason for evaluation, treatment, and outcome for dogs and cats with presumed solitary ocular lymphoma (PSOL). Design—Retrospective case series. Animals—7 dogs and 2 cats with PSOL. Procedures—Medical records were reviewed. Progression-free survival time (PFST) and overall survival time (OST) were determined. Results—Animals with intraocular (4 dogs and 1 cat) or conjunctival (3 dogs and 1 cat) lymphoma represented 0.1% and 0.08% of patients with lymphoma evaluated at the hospital during the study period, respectively. Animals with intraocular lymphoma represented 0.19% of all patients with uveitis; animals with conjunctival lymphoma represented 0.16% of all patients with conjunctivitis. Tumors included B-cell (2 intraocular and 1 conjunctival), non–B-cell, non–T-cell (1 intraocular), and T-cell (3 conjunctival) neoplasms; immunophenotype of 2 uveal lymphomas was not determined. Treatments included enucleation (4 intraocular) and chemotherapy (3 intraocular and 2 conjunctival). All dogs with intraocular lymphoma developed neurologic signs. Lymph node metastasis was detected in 2 patients with conjunctival lymphoma. Median PFST and OST were 178 days for all animals with PSOL, dogs with PSOL, and animals with intraocular lymphoma. Median PFST and OST for animals with conjunctival lymphoma were 221 and 549 days, respectively. Conclusions and Clinical Relevance—Results indicated PSOL was uncommon, but should be considered a differential diagnosis for animals with uveitis or conjunctivitis. Performance of MRI and cytologic analysis of CSF and regional lymph node aspirate samples may be beneficial for such patients. Prognosis seemed to be better for animals with conjunctival lymphoma than it was for those with intraocular lymphoma.

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Treatment Effects and Sequelae of Radiation Therapy for Orbital Mucosa-Associated Lymphoid Tissue Lymphoma

Cited by 21 publications

References 30 publications

Long-term course of patients with primary ocular adnexal MALT lymphoma: a large single-institution cohort study

Long-term course of patients with primary ocular adnexal MALT lymphoma: a large single-institution cohort study

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

Presumed solitary intraocular or conjunctival lymphoma in dogs and cats: 9 cases (1985–2013)

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