title: Localized ocular adnexal mucosa-associated lymphoid tissue lymphoma treated with radiation therapy: a long-term outcome in 86 patients with 104 treated eyes.
abstract: OBJECTIVE
  To evaluate the natural history, behavior of progression, prognostic factors, and treatment-related adverse effects of primary ocular adnexal mucosa-associated lymphoid tissue (MALT) lymphoma (POAML).
  
  
  METHODS
  Eighty-six patients with histologically proven stage I POAML treated with radiation therapy at National Cancer Center Hospital, Tokyo between 1990 and 2010 were retrospectively reviewed. The median age was 56 years (range, 18-85 years). The median dose administered was 30 Gy (range, 30-46 Gy). Seventy-seven patients (90%) were treated by radiation therapy alone.
  
  
  RESULTS
  The median follow-up duration was 9 years (range, 0.9-22 years). The 5- and 10-year overall survival (OS) rates were 97.6% and 93.5%, respectively, and no patients died of lymphoma. Patients with tumor sizes ≥4 cm showed a greater risk of contralateral relapse (P=.012). Six patients with contralateral relapse were seen and treated by radiation therapy alone, and all the lesions were controlled well, with follow-up times of 3 to 12 years. There was 1 case of local relapse after radiation therapy alone, and 3 cases of relapse occurred in a distant site. Cataracts developed in 36 of the 65 eyes treated without lens shielding and in 12 of the 39 patients with lens shielding (P=.037).
  
  
  CONCLUSIONS
  The majority of patients with POAML showed behavior consistent with that of localized, indolent diseases. Thirty gray of local irradiation seems to be quite effective. The initial bilateral involvement and contralateral orbital relapses can be also controlled with radiation therapy alone. Lens shielding reduces the risk of cataract.
authors: Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan. Electronic address: keharada@ncc.go.jp.
authors: Ken
authors: K
authors: Harada
authors: Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan.
authors: Naoya
authors: N
authors: Murakami
authors: Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan.
authors: Mayuka
authors: M
authors: Kitaguchi
authors: Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan.
authors: Shuhei
authors: S
authors: Sekii
authors: Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan.
authors: Kana
authors: K
authors: Takahashi
authors: Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan.
authors: Kotaro
authors: K
authors: Yoshio
authors: Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan.
authors: Koji
authors: K
authors: Inaba
authors: Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan.
authors: Madoka
authors: M
authors: Morota
authors: Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan.
authors: Yoshinori
authors: Y
authors: Ito
authors: Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan.
authors: Minako
authors: M
authors: Sumi
authors: Department of Ophthalmic Oncology, National Cancer Center Hospital, Tokyo, Japan.
authors: Shigenobu
authors: S
authors: Suzuki
authors: Department of Hematologic Oncology, National Cancer Center Hospital, Tokyo, Japan.
authors: Kensei
authors: K
authors: Tobinai
authors: Department of Radiology, Chiba University School of Medicine, Chiba, Japan.
authors: Takashi
authors: T
authors: Uno
authors: Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan.
authors: Jun
authors: J
authors: Itami
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D002386:Cataract / Q000517:prevention & control; D003520:Cyclophosphamide / Q000008:administration & dosage; D018450:Disease Progression; D004317:Doxorubicin / Q000008:administration & dosage; D005134:Eye Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D007564:Japan; D018442:Lymphoma, B-Cell, Marginal Zone / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009918:Orbital Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D011241:Prednisone / Q000008:administration & dosage; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D000069283:Rituximab; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone