title: Outcomes of primary lymphoma of the ocular adnexa (orbital lymphoma) treated with radiotherapy.
abstract: OBJECTIVE
  Low-grade ocular adnexal lymphoma is a rare disease and often treated with local radiotherapy to varying doses. Most previously reported studies have a very heterogeneous patient population and treatments. We report the outcomes from a 10 year cohort of patients at our institution treated with primary radiation therapy.
  
  
  METHODS
  We analysed a retrospective case series of patients with stage IE low-grade ocular adnexal lymphoma including a review of case notes, histological reports and radiotherapy charts. We assessed local and distant tumour control and relapse rates in addition to toxicity. Disease-free survival was estimated using the Kaplan-Meier method.
  
  
  RESULTS
  In total, 81 patients and 85 orbits were treated with primary radiotherapy to a median dose of 30 Gy in 15 fractions over 3 weeks. Seventy-nine per cent were treated with standard MV external beam radiotherapy to the whole orbit and 21% with a lens-sparing technique. The median follow-up was 4.4 years (range 0.2-10.4). Local control rates were 100%, with 5% of patients experiencing disease relapse elsewhere. No patients died from lymphoma. Cumulative acute toxicity rates were 51% (mainly erythema and conjunctivitis) and late toxicity rates were 8% (mainly cataract). The lens-sparing technique was associated with a significant reduction in cataract rate (P = 0.013) and an increase in acute toxicity (P < 0.001).
  
  
  CONCLUSIONS
  This study has shown excellent local control rates and acceptable toxicity from the treatment of stage IE low-grade ocular adnexal lymphoma with localised radiotherapy to a median dose of 30 Gy in 15 fractions over 3 weeks.
authors.affiliation: Mount Vernon Cancer Centre, Northwood, UK. Electronic address: dwoolf@doctors.org.uk.
authors.forename: D K
authors.initials: DK
authors.lastname: Woolf
authors.affiliation: St Bartholomews' Hospital, London, UK.
authors.forename: H
authors.initials: H
authors.lastname: Kuhan
authors.affiliation: St Bartholomews' Hospital, London, UK.
authors.forename: O
authors.initials: O
authors.lastname: Shoffren
authors.affiliation: St Bartholomews' Hospital, London, UK.
authors.forename: E M
authors.initials: EM
authors.lastname: Akinnawo
authors.affiliation: St Bartholomews' Hospital, London, UK.
authors.forename: B
authors.initials: B
authors.lastname: Sivagurunathan
authors.affiliation: St Bartholomews' Hospital, London, UK.
authors.forename: H
authors.initials: H
authors.lastname: Boyce
authors.affiliation: St Bartholomews' Hospital, London, UK.
authors.forename: P N
authors.initials: PN
authors.lastname: Plowman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008223:Lymphoma / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009918:Orbital Neoplasms / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: Lens-sparing radiotherapy; ocular adnexal lymphoma; ocular radiotherapy