Orbital lymphoma: is it necessary to treat the entire orbit?
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.
Pfeffer
M Raphael
MR
Department of Radiation Oncology, Chaim Sheba Medical Center, Tel Hashomer, Israel. raphipf@sheba.gov.il
Rabin
Tatiana
T
Tsvang
Lev
L
Goffman
Janna
J
Rosen
Nahum
N
Symon
Zvi
Z
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