Long-Term Outcome and Patterns of Failure in Primary Ocular Adnexal Mucosa-Associated Lymphoid Tissue Lymphoma Treated With Radiotherapy

• Published in: International journal of radiation oncology, biology, physics Vol. 82; no. 4; pp. 1509 - 1514
• Main Authors: Hashimoto, Naoki, Sasaki, Ryohei, Nishimura, Hideki, Yoshida, Kenji, Miyawaki, Daisuke, Nakayama, Masao, Uehara, Kazuyuki, Okamoto, Yoshiaki, Ejima, Yasuo, Azumi, Atsushi, Matsui, Toshimitsu, Sugimura, Kazuro
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 15.03.2012; Elsevier
• Subjects: Adult; Aged; Aged, 80 and over; Antibodies, Monoclonal, Murine-Derived - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; CATARACTS; Cause of Death; CHEMOTHERAPY; CONJUNCTIVA; Cyclophosphamide - administration & dosage; DISEASE INCIDENCE; Disease Progression; Disease-Free Survival; Doxorubicin - administration & dosage; Eye Neoplasms - drug therapy; Eye Neoplasms - mortality; Eye Neoplasms - pathology; Eye Neoplasms - radiotherapy; FAILURES; Female; FEMALES; GLANDS; Hematologic and hematopoietic diseases; Hematology, Oncology and Palliative Medicine; Humans; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Lymphoma, B-Cell, Marginal Zone - drug therapy; Lymphoma, B-Cell, Marginal Zone - mortality; Lymphoma, B-Cell, Marginal Zone - pathology; Lymphoma, B-Cell, Marginal Zone - radiotherapy; LYMPHOMAS; Male; MALES; MALT lymphoma; Medical sciences; Middle Aged; Neoplasm Recurrence, Local - pathology; Ocular adnexal lymphoma; PATIENTS; Pattern of failure; Prednisone - administration & dosage; RADIATION DOSES; Radiology; RADIOLOGY AND NUCLEAR MEDICINE; RADIOTHERAPY; Radiotherapy Dosage; Retrospective Studies; Rituximab; Treatment Failure; Vincristine - administration & dosage; Young Adult; Pattern of failure; MALT lymphoma; Radiotherapy; Ocular adnexal lymphoma; Prognosis; Malignant hemopathy; Ocular lymphoma; Non Hodgkin lymphoma; Long term; Eye; Cancerology; Treatment; Lymphoproliferative syndrome; Primary; Cancer
• ISSN: 0360-3016; 1879-355X; 1879-355X
• DOI: 10.1016/j.ijrobp.2011.04.052

To evaluate the long-term treatment outcome and disease behavior of primary ocular adnexal MALT (mucosa-associated lymphoid tissue) lymphoma (POAML) after treatment with radiotherapy. Seventy-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. The 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. Radiotherapy 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.