• Int. J. Radiat. Oncol. Biol. Phys. · Mar 2012

    Long-term outcome and patterns of failure in primary ocular adnexal mucosa-associated lymphoid tissue lymphoma treated with radiotherapy.

    • Naoki Hashimoto, Ryohei Sasaki, Hideki Nishimura, Kenji Yoshida, Daisuke Miyawaki, Masao Nakayama, Kazuyuki Uehara, Yoshiaki Okamoto, Yasuo Ejima, Atsushi Azumi, Toshimitsu Matsui, and Kazuro Sugimura.
    • Division of Radiation Oncology, Kobe University Graduate School of Medicine, Hyogo, Japan.
    • Int. J. Radiat. Oncol. Biol. Phys. 2012 Mar 15; 82 (4): 1509-14.

    PurposeTo evaluate the long-term treatment outcome and disease behavior of primary ocular adnexal MALT (mucosa-associated lymphoid tissue) lymphoma (POAML) after treatment with radiotherapy.Methods And MaterialsSeventy-eight patients (42 male, 36 female) diagnosed with stage I POAML between 1991 and 2010 at Kobe University Hospital were included. The median age was 60 years (range, 22-85 years). The median radiation dose administered was 30.6 Gy. Rituximab-based targeted therapy and/or chemotherapy was performed in 20 patients (25.6%). Local control (LC), recurrence-free survival (RFS), and overall survival (OS) rates were calculated using the Kaplan-Meier method.ResultsThe median follow-up duration was 66 months. Major tumor sites were conjunctiva in 37 patients (47.4%), orbita in 29 (37.2%), and lacrimal glands in 12 (15.4%). The 5- and 10-year OS rates were 98.1% and 95.3%, respectively. The 5- and 10-year LC rates were both 100%, and the 5- and 10-year RFS rates were 88.5% and 75.9%, respectively. Patients treated with a combination of radiotherapy and targeted therapy and/or chemotherapy had a trend for a better RFS compared with those treated with radiotherapy alone (p = 0.114). None developed greater than Grade 2 acute morbidity. There were 14 patients who experienced Grade 2 morbidities (cataract: 14; retinal disorders: 7; dry eye: 3), 23 patients who had Grade 3 morbidities (cataract: 23; dry eye: 1), and 1 patient who had Grade 4 glaucoma.ConclusionsRadiotherapy for POAML was shown to be highly effective and safe for LC and OS on the basis of long-term observation. The absence of systemic relapse in patients with combined-modality treatment suggests that lower doses of radiation combined with targeted therapy may be worth further study.Copyright © 2012 Elsevier Inc. All rights reserved.

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