Palliative radiotherapy of retrobulbar orbit metastases due to breast cancer.
BACKGROUND
In breast cancer, the occurrence of retrobulbar metastases of the orbit is rare compared to intraocular metastases. The clinical symptoms are quite different. Impairment of vision, exophthalmus, double vision, vertigo, and pain reduce patients' quality of life.


METHODS
The benefit of palliative irradiation of the orbit was researched retrospectively in 7 patients. This report also presents the first case in the literature of a breast cancer patient with bi-orbital enophthalmus caused by bilateral retrobulbar metastases that were successfully treated with radiotherapy. Irradiation was performed by photon or electron beams (20-50 Gy). Clinical restaging was done at the end of radiotherapy and 6 weeks thereafter.


RESULTS
After irradiation, 6 out of 7 patients showed a distinct clinical response with good palliation and no major side effects. Exophthalmus, pain, and vertigo were significantly reduced in all cases. Double vision disappeared in 3 out of 4 patients, eye muscle paralysis in 5 out of 6 patients. The median overall survival after irradiation of the orbit was 7.3 months.


CONCLUSIONS
Palliative radiotherapy of retrobulbar metastases of breast cancer is very effective in reducing acute clinical symptoms and increasing quality of life. Nonetheless, patients have a poor prognosis.
Department of Radiation Oncology, University of Heidelberg, Heidelberg, Germany. felix.zwicker@med.uni-heidelberg.de
Felix
F
Zwicker
Klaus
K
Herfarth
Thomas
T
Welzel
Sebastian
S
Aulmann
Stefan
S
Dithmar
Holger
H
Hof
Jürgen
J
Debus
D000368:Aged; D001943:Breast Neoplasms / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009918:Orbital Neoplasms / Q000532:radiotherapy* / Q000556:secondary*; D010166:Palliative Care / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome