Orbital lymphoma: radiotherapy outcome and complications

Author(s): Stafford SL, Kozelsky TF, Garrity JA

Abstract

Background and purpose:Orbital non-Hodgkin's lymphomas (NHL) have traditionally been treated with radiation. Forty-eight patients presenting with orbital NHL were treated with radiation and were evaluated for local control, overall survival, cause-specific survival, and complications.

Materials and methods:Forty-five patients had low-grade and 3 patients had intermediate-grade histologic findings. Orbit-only disease occurred in 22 patients, the conjunctiva in 16, both in five, and lacrimal gland only in five. Patient age ranged from 35 to 94 years (median, 68). Ann Arbor stages were cIEA (34), cIIEA (six), cIIIEA (two), and cIVEA (six). Radiation doses ranged between 15 and 53.8 Gy (median, 27.5 Gy).

Results:Follow-up ranged from 0.14 to 18.23 years (median, 5.35). Median overall survival and cause-specific survival were 6.5 and 15.5 years, respectively. Patients with clinical stage I or II disease had significantly better overall and cause-specific survival than patients with stage III or IV disease. Ten-year relapse-free survival in 41 patients with stage I or II disease was 66%. However, there was continued downward pressure on relapse-free survival out to 18 years. One local failure occurred. Twenty-five patients sustained acute complications. There were 17 minor and four major late complications. All major late complications occurred with doses more than 35 Gy.

Conclusions:Excellent local control with radiation doses ranging from 15 to 30 Gy is achieved. Patients with stage I or II disease have better overall and cause-specific survival than patients with stage III or IV disease. Late relapse occurs in sites other than the treated orbit, even in patients with early-stage disease. Doses 35 Gy or higher result in significant late complications and are therefore not indicated for patients with low-grade tumors.

Similar Articles

WHO classification: tumors of hematopoietic and lymphoid tissues

Author(s): Jaffe ES, Harris NL, Stein H, Vardiman JW

Lymphoreticular tumors of the orbit

Author(s): Fitzpatrick PJ, Macko S

Malignant tumors of the orbit

Author(s): Margo CE, Mulla ZD

Ocular adnexal lymphoma: clinical behavior of distinct World Health Organization classification subtypes

Author(s): Fung CY, Tarbell NJ, Lucarelli MJ, Goldberg SI, Linggood RM, et al.

Role of radiotherapy for primary orbital lymphoma

Author(s): Lee SW, Suh CO, Kim GE

Radiation dose to the lens and cataract formation

Author(s): Henk JM, Whitelocke RA, Warrington AP

Primary radiotherapy for localized orbital MALT lymphoma

Author(s): Le QT, Eulau SM, George TI