title: Postoperative radiotherapy with volumetric modulated arc therapy of lacrimal gland carcinoma: two case reports and literature review.
abstract: OBJECTIVE
  To evaluate technical issues and clinical outcomes after postoperative volumetric-modulated arc therapy (VMAT) in two cases of malignant lacrimal gland cancer.
  
  
  METHODS
  Patients were treated by postoperative VMAT and post-treatment clinical outcomes were followed-up to 18 months.
  
  
  RESULTS
  Dosimetric results were acceptable and acute toxicity was manageable in both patients. No evidence of disease was found at latest follow-up. One patient underwent corneal transplant for central corneal ulceration, experiencing reduction of visual acuity.
  
  
  CONCLUSIONS
  Postoperative VMAT for treatment of lacrimal gland tumors offers improved outcome, with manageable side effects. In the context of photon beam radiotherapy, VMAT emerged as a valuable treatment option for these malignant tumors.
authors.affiliation: Units of Radiotherapy 2, Fondazione IRCCS Istituto Nazionale Tumori, Via Giacomo Venezian, 1, 20133 Milan, Italy.
authors.forename: Ester
authors.initials: E
authors.lastname: Orlandi
authors.forename: Silvia
authors.initials: S
authors.lastname: Takanen
authors.forename: Tommaso
authors.initials: T
authors.lastname: Giandini
authors.forename: Eva
authors.initials: E
authors.lastname: Iannacone
authors.forename: Walter
authors.initials: W
authors.lastname: Fontanella
authors.forename: Laura
authors.initials: L
authors.lastname: Locati
authors.forename: Mauro
authors.initials: M
authors.lastname: Carrara
authors.forename: Paolo
authors.initials: P
authors.lastname: Bossi
authors.forename: Cristiana
authors.initials: C
authors.lastname: Bergamini
authors.forename: Roberta
authors.initials: R
authors.lastname: Granata
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Tombolini
authors.forename: Tullio
authors.initials: T
authors.lastname: Ibba
authors.forename: Lisa
authors.initials: L
authors.lastname: Licitra
authors.forename: Emanuele
authors.initials: E
authors.lastname: Pignoli
authors.forename: Carlo
authors.initials: C
authors.lastname: Fallai
mesh_terms: D000328:Adult; D002277:Carcinoma / Q000175:diagnosis / Q000532:radiotherapy* / Q000601:surgery; D005134:Eye Neoplasms / Q000175:diagnosis / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D006801:Humans; D007765:Lacrimal Apparatus / Q000473:pathology* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D011182:Postoperative Care; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods; D016896:Treatment Outcome
keywords: VMAT; adenoid cystic carcinoma; carcinoma ex pleomorphic adenoma; dosimetric evaluation; lacrimal gland tumor; postoperative intensity-modulated radiation therapy; treatment planning