title: Orbital lymphoma: is it necessary to treat the entire orbit?
abstract: OBJECTIVE
  Conformal radiotherapy (RT) has been used for all patients with orbital lymphoma treated at our institution since 1997. We retrospectively reviewed the charts of 23 consecutive patients to test the hypothesis that partial orbit RT is effective and less toxic than whole orbit RT.
  
  
  METHODS
  Twelve patients with limited lesions were treated to partial orbital volumes and 11 patients (1 with bilateral disease) with more extensive lesions received whole orbit RT. The dose was 20-30 Gy (median, 25.2 Gy) for 19 patients with low-grade lymphoma and 24-40 Gy (median, 39.6 Gy) for 5 patients with intermediate- to high-grade lymphoma. The follow-up was 12-68 months (median, 34 months).
  
  
  RESULTS
  All patients had a complete response to RT. Intraorbital recurrence developed in previously uninvolved areas not included in the initial target volume in 4 patients (33%) treated with partial orbit RT. All were salvaged by repeat RT or surgery. No patient treated with whole orbit RT developed intraorbital recurrence. The acute and long-term toxicity was similar in both groups. All but 1 patient retained good vision.
  
  
  CONCLUSIONS
  Patients with orbital lymphoma should be treated to the entire orbit. An effective dose of RT for low-grade lesions is 25 Gy, which results in minimal morbidity even when delivered to the entire orbit.
authors.affiliation: Department of Radiation Oncology, Chaim Sheba Medical Center, Tel Hashomer, Israel. raphipf@sheba.gov.il
authors.forename: M Raphael
authors.initials: MR
authors.lastname: Pfeffer
authors.forename: Tatiana
authors.initials: T
authors.lastname: Rabin
authors.forename: Lev
authors.initials: L
authors.lastname: Tsvang
authors.forename: Janna
authors.initials: J
authors.lastname: Goffman
authors.forename: Nahum
authors.initials: N
authors.lastname: Rosen
authors.forename: Zvi
authors.initials: Z
authors.lastname: Symon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D018442:Lymphoma, B-Cell, Marginal Zone / Q000532:radiotherapy; D008228:Lymphoma, Non-Hodgkin / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009915:Orbit; D009918:Orbital Neoplasms / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D020266:Radiotherapy, Conformal; D012189:Retrospective Studies