Periocular lymphoproliferative diseases: natural history, prognostic factors, and treatment.
A study was undertaken to assess the natural history of periocular lymphoproliferative diseases, identify key prognostic factors, and clarify the role of orbital irradiation. Thirty-four patients with periocular lymphoproliferative disease were treated with orbital irradiation between 1975 and 1990. Eight patients had atypical lymphoid infiltrate, and 26 had malignant lymphoma. Forty-three eyes were irradiated with en-face electrons or 6-MV photons. Five-year disease-free survival for all stages was 65%; it was not significantly affected by bilaterality or site. Stage, distinction between atypical lymphoid infiltrate and malignant lymphoma, and working formulation grade were important prognostic indicators. A complete response during irradiation was achieved in 24 of 43 (56%) eyes at a median dose of 2,400 cGy, and a partial response was achieved in 19 (44%), with resolution at a median of 2.8 months. Patients with periocular reactive lymphoid hyperplasia or atypical lymphoid infiltrate may have or are at significant risk of developing lymphoma and dissemination. Local treatment remains important; orbital irradiation achieves prompt local control with acceptable morbidity.
Erickson
B A
BA
Department of Radiation Oncology, Medical College of Wisconsin Affiliated Hospitals, Milwaukee 53226.
Harris
G J
GJ
Enke
C A
CA
Murray
K J
KJ
Massaro
B M
BM
Hanson
G A
GA
Hansen
R M
RM
Anderson
T
T
Wilson
J F
JF
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D016130:Immunophenotyping; D008223:Lymphoma / Q000276:immunology / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009918:Orbital Neoplasms / Q000276:immunology / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D011829:Radiation Dosage