An International Lymphoma Radiation Oncology Group study of radiotherapy for bilateral indolent orbital adnexal lymphomas.

IF 6.4 1区医学 Q1 ONCOLOGY

International Journal of Radiation Oncology Biology Physics Pub Date : 2025-03-14 DOI:10.1016/j.ijrobp.2025.03.011

Krystel Tran, Dongryul Oh, Richard Tsang, Chang-Ok Suh, Hong-In Yoon, Hwa Kyung Byun, Senzo Taguchi, Jill Gunther, Bouthaina Dabaja, Chelsea Pinnix, John Plastaras, Christopher Wright, Brandon S Imber, Joachim Yahalom, Khaled Elsayad, Hans Eich, Andrea Ng, Rachel Rabinovitch, Michael Binkley, Richard Hoppe, Jessica Brady, George Mikhaeel, Xinyue Wang, Shunan Qi, Mario Levis, Umberto Ricardi, Maggie Harris, Tim Illidge, Michael MacManus, Mathias Bressel, Andrew Wirth

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引用次数: 0

Abstract

Purpose/objectives: Radiotherapy (RT) is curative for the majority of patients with primary indolent orbital adnexal lymphoma (IOAL). Some reports suggest inferior outcomes for bilateral IOAL, leading to uncertainty regarding optimal management for this presentation. This multicentre, retrospective study evaluated long-term outcomes of bilateral IOAL patients treated with radiotherapy alone.

Materials/methods: One hundred and eighty-four patients with synchronous (defined as ≤90 days between orbit diagnoses), or metachronous bilateral IOAL, and no prior lymphoma history, received radiotherapy to both orbits. Overall (OS), failure-free survival (FFS), freedom from local (FFLF) and distant (FFDF) failure and toxicity were evaluated. The study met local institutional review board requirements.

Results: A total of 184 patients were treated for IOAL from 16 centres. The median age at first orbit diagnosis was 51 years (15-91 years) with 170 (92%) of patients having MZL. Disease location included the conjunctiva in 265 (72%) of orbits. The RT dose (per orbit) was 4 Gy for 40 (11%), 20-26 Gy for 217 (59%), 27-30.6 Gy for 87 (24%), >30.6 Gy for 24 (6.5%). Radiotherapy volume was whole orbit for 162 (44%), conjunctiva only for 177 (48%) and other partial orbit for 29 (8%). The median follow-up was 5.7 years. Ten-year OS and FFS were 99% (95% CI: 95-100) and 72% (95% CI: 62-79), respectively. Ten-year FFLF and FFDF were 87% (95% CI: 80-92) and 81% (95% CI: 72-88), respectively. Ten-year FFS was 85% (95% CI: 75-91) and 50% (95% CI: 32-65) for patients with conjunctival-only disease versus any non-conjunctival disease, respectively. Late toxicities included dry eye in 42% of patients (grade 1 in 86%) and cataract in 27%.

Conclusions: In this large, multicentre experience, patients with bilateral IOAL treated with radiotherapy alone had outcomes comparable to historical series of unilateral disease. These results support the treatment of bilateral IOAL as a localised process with curative intent radiotherapy.

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来源期刊

International Journal of Radiation Oncology Biology Physics 医学-核医学

CiteScore

11.00

自引率

7.10%

发文量

2538

审稿时长

6.6 weeks

期刊介绍： International Journal of Radiation Oncology • Biology • Physics (IJROBP), known in the field as the Red Journal, publishes original laboratory and clinical investigations related to radiation oncology, radiation biology, medical physics, and both education and health policy as it relates to the field. This journal has a particular interest in original contributions of the following types: prospective clinical trials, outcomes research, and large database interrogation. In addition, it seeks reports of high-impact innovations in single or combined modality treatment, tumor sensitization, normal tissue protection (including both precision avoidance and pharmacologic means), brachytherapy, particle irradiation, and cancer imaging. Technical advances related to dosimetry and conformal radiation treatment planning are of interest, as are basic science studies investigating tumor physiology and the molecular biology underlying cancer and normal tissue radiation response.