Treatment outcomes for primary intraocular lymphoma: implications for external beam radiotherapy

Berenbom, A; Rm, Davila; Hs, Lin; Jw, Harbour

doi:10.1038/sj.eye.6702437

Cited by 99 publications

(76 citation statements)

References 11 publications

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“…163,183 The mean age of presentation is in the fifth and sixth decades of life. 19,51,85,163,213 Some reports suggest a sex bias, with women more commonly affected than men by 2:1 15,21,163 or even greater. 27,168 More recently there appears to have been an increase of reported 6 cases in men.…”

Section: Epidemiologymentioning

confidence: 99%

“…Mortality rates range between 9% and 81% in follow-up periods ranging from 12 to 35 months. 2,11,15,27,42,51,71,85,113 Often, diagnosis is delayed. In PCNSL, median survival of patients treated with radiotherapy alone or chemotherapy plus radiotherapy ranges from 10e16 months, which can be extended to greater than 30 months with methotrexate-based chemotherapy 165 or by ifosfamide or trofosfamide.…”

Section: Prognosismentioning

confidence: 99%

“…144 In a series of 12 patients with PIOL receiving either chemotherapy alone, radiotherapy alone or a combination, there were no ocular relapses in any patients who had received radiotherapy (30e35 Gy in 15 fractions) during a mean follow-up of 19 months. 15 Localized brain radiotherapy is typically used first line to treat primary CNS lymphoma. If vitreoretinal lymphoma occurs following treatment of CNS lymphoma, whole eye radiotherapy may be added.…”

Section: Radiotherapymentioning

confidence: 99%

See 2 more Smart Citations

Primary Intraocular Lymphoma

Seshadri¹,

Jena²,

Tripathy³

2017

Ophthalmology: Current and Future Developments

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Section: Epidemiologymentioning

confidence: 99%

Section: Prognosismentioning

confidence: 99%

Section: Radiotherapymentioning

confidence: 99%

See 1 more Smart Citation

Primary Intraocular Lymphoma

Seshadri¹,

Jena²,

Tripathy³

2017

Ophthalmology: Current and Future Developments

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“…Dosing typically entails a total of 35-50 Gy delivered in 1.5-2.0 Gy fractions using a pair of lateral opposed fields of photon beams [11,17,45]. Reports indicate that rates of visually significant radiation-induced retinopathy are low in patients undergoing EBRT, and that typically no attempt is made to spare the lens given the risk of missing malignancy in the anterior vitreous and the ease of surgical cataract repair [4,5,45]. However, Pe'er et al, postulate that the true incidence of radiation retinopathy is likely masked by patient mortality and the resulting short follow-up period status-post treatment [11].…”

Section: Radiation Therapymentioning

confidence: 99%

“…To date, no formal standards exist for the treatment of this condition, but many therapies have been experimentally employed. For those with no concomitant CNS disease, high dose intravenous (IV) methotrexate with adjuvant local radiation [5,6] and intraocular methotrexate injections [7][8][9] have been popular in the literature.…”

Section: Introductionmentioning

confidence: 99%

The evaluation and treatment of primary intraocular lymphoma

Hanson¹,

Alexandru²,

Bota³

2013

J Cancer Ther Res

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Primary intraocular lymphoma (PIOL) is a relatively rare form of Non-Hodgkin's Lymphoma arising in the lymphoid tissues of the eye. It is highly correlated with primary CNS lymphoma (PCNSL) and it is estimated that up to 80% of patients presenting with PIOL will eventually manifest intracranial malignancy, which is the largest contributor to mortality. Most patients present with nonspecific visual symptoms, including floaters and blurry vision, and are often initially diagnosed with uveitis or retinitis. Definitive diagnosis requires biopsy of malignant tissues with demonstration of malignant lymphoid cells. Optimal therapy is to this point undefined, and the available literature is limited to case reports and retrospective series. Currently employed therapies include the use of localized external beam radiation therapy (EBRT), whole brain radiation therapy (WBRT), systemic chemotherapy, intrathecal chemotherapy, and, most recently, direct intravitreal (IVT) chemotherapy. While radiation therapy and chemotherapy can produce a high response rate, they have not been shown to effectively prevent relapse or the incidence of CNS spread. Methotrexate has been the most popular therapy used for the treatment of intraocular lymphoma. It has been administered systemically, intrathecally or intravitreally. However due to multiple mechanisms of resistance developed by lymphoma cells against methotrexate, this drug has been unable to prevent disease recurrence. The newest, and perhaps most promising, reported therapy includes the use of rituximab anti-CD20 monoclonal antibody either alone or in combination chemotherapy via intrathecal or IVT administration. Most cases in the literature employ combinations of available therapies, and there are no comparative studies of significant power to date. Multicenter collaboration will be required to determine the true relative efficacy and adversity of the therapeutic options available.

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CyberKnife Radiosurgery for the Treatment of Intraocular and Periocular Lymphoma

Bianciotto

Shields²,

Lally³

et al. 2010

Arch Ophthalmol

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To evaluate efficacy, patient tolerance, and adverse effects of CyberKnife radiosurgery for the treatment of intraocular and periocular lymphoma. Methods: Retrospective case series of 13 patients who underwent CyberKnife radiosurgery was conducted. Results: Fourteen eyes of 13 patients were included. The tissue location of the lymphoma was orbit (7 eyes), conjunctiva (3 eyes), choroid (2 eyes), and retina (2 eyes). The lymphoma type was classified as extranodal marginal zone B-cell lymphoma in 7 eyes (50%), diffuse large B-cell lymphoma in 3 eyes (21%), follicular lymphoma in 2 eyes (14%), and benign reactive lymphoid hyperplasia in 2 eyes (14%). The mean treatment dose was 1718 centigrays (cGy) (range, 1350-2250 cGy) given over a mean of 5 days (range, 3-5 days) with a mean dose rate of 320 cGy per fraction. Complete tumor resolution without local recurrence over a mean follow-up of 23 months was documented in all cases. Radiation-associated adverse effects included mild dry eye in 2 patients and cataract in 1 patient with conjunctival lymphoma. There was no radiation retinopathy or papillopathy, and visual acuity was preserved or improved in 13 eyes and decreased in 1 eye due to the presence of cataract. Conclusions: CyberKnife radiosurgery is a welltolerated technique for the treatment of intraocular and periocular lymphoma, allowing for local resolution of the lesions. An important benefit is that treatment was completed over 5 days.

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Treatment outcomes for primary intraocular lymphoma: implications for external beam radiotherapy

Cited by 99 publications

References 11 publications

Primary Intraocular Lymphoma

Primary Intraocular Lymphoma

The evaluation and treatment of primary intraocular lymphoma

CyberKnife Radiosurgery for the Treatment of Intraocular and Periocular Lymphoma

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