Extranodal Marginal Zone Lymphoma of Ocular Adnexa: Outcomes following Radiation TherapyPlatt S.a · Al Zahrani Y.a · Singh N.b · Hill B.c · Cherian S.d · Singh A.D.a
aDepartment of Ophthalmic Oncology, Cole Eye Institute, bCase Western Reserve University School of Medicine, cDepartment of Hematologic Oncology and Blood Disorders, Taussig Cancer Institute, and dDepartment of Radiation Oncology, Cleveland Clinic, Cleveland, OH, USA
Do you have an account?
- Rent for 48h to view
- Buy Cloud Access for unlimited viewing via different devices
- Synchronizing in the ReadCube Cloud
- Printing and saving restrictions apply
Rental: USD 8.50
Cloud: USD 20.00
Article / Publication Details
Aim: The aim of this study was to report outcomes following radiation therapy in patients with biopsy-proven extranodal marginal zone lymphoma of the ocular adnexa and uvea. Methods: Records from a single institution were retrospectively reviewed from January 1997 to December 2015. The mean follow-up duration was 38 months (range 0-194). Radiation therapy was administered to 77 eyes (60 patients); 57 of the 77 eyes (74%) were treated with radiation only (range 20-36 Gy, median 15 fractions). Radiation cataract, radiation retinopathy, and optic neuropathy assessments were performed on all eyes treated with radiation. Results: 100% of the 47 patients treated with radiation therapy only had local control with an average dose of 26.5 Gy (median 25.2 [range 20-36] Gy; 150-200 cGy per fraction). Four patients lost 2 lines or more of vision after radiation. The most common complication of radiation therapy was cataract formation/progression in 19 eyes (25%). Radiation retinopathy was observed only in 1 patient (1%). Conclusion: Our results confirm that radiation therapy (median 25 Gy) for extranodal marginal zone lymphoma of the ocular adnexa is associated with high local control and low risk of visually significant complications.
© 2017 S. Karger AG, Basel
- Thieblemont C: Clinical presentation and management of marginal zone lymphomas. Hematology Am Soc Hematol Educ Program 2005:307-313.
- Thieblemont C, Coiffier B: Management of marginal zone lymphomas. Curr Treat Options Oncol 2006;7:213-222.
- Freeman C, Berg JW, Cutler SJ: Occurrence and prognosis of extranodal lymphomas. Cancer 1972;29:252-260.
- Lim SH, Kang M, Son J: Extranodal marginal zone B cell lymphoma of mucosa-associated lymphoid tissue type of the ocular adnexa: retrospective single institution review of 95 patients. Indian J Ophthalmol 2011;59:273-277.
- Fung CY, Tarbell NJ, Lucarelli MJ, et al: Ocular adnexal lymphoma: clinical behavior of distinct World Health Organization classification subtypes. Int J Radiat Oncol Biol Phys 2003;57:1382-1391.
- Hata M, Kaneko A, Tomita N, Inoue T: Severe retinopathy following radiation therapy with a moderate dose for orbital mucosa-associated lymphoid tissue lymphoma. Hematol Oncol 2014;32:212-214.
- Isaacson P, Wright DH: Malignant lymphoma of mucosa-associated lymphoid tissue. A distinctive type of B-cell lymphoma. Cancer 1983;52:1410-1416.
- Cho WK, Lee SE, Paik JS, Cho SG, Yang SW: Risk potentiality of frontline radiotherapy associated cataract in primary ocular adnexal mucosa-associated lymphoid tissue lymphoma. Korean J Ophthalmol 2013;27:243-248.
- Aronow ME, Portell CA, Sweetenham JW, Singh AD: Uveal lymphoma: clinical features, diagnostic studies, treatment selection, and outcomes. Ophthalmology 2014;121:334-341.
- Portell CA, Aronow ME, Rybicki LA, Macklis R, Singh AD, Sweetenham JW: Clinical characteristics of 95 patients with ocular adnexal and uveal lymphoma: treatment outcomes in extranodal marginal zone subtype. Clin Lymphoma Myeloma Leuk 2014;14:203-210.
- De Cicco L, Cella L, Liuzzi R, et al: Radiation therapy in primary orbital lymphoma: a single institution retrospective analysis. Radiat Oncol 2009;4:60.
- Hashimoto N, Sasaki R, Nishimura H, et al: Long-term outcome and patterns of failure in primary ocular adnexal mucosa-associated lymphoid tissue lymphoma treated with radiotherapy. Int J Radiat Oncol Biol Phys 2012;82:1509-1514.
- Fuller ML, Sweetenham J, Schoenfield L, Singh AD: Uveal lymphoma: a variant of ocular adnexal lymphoma. Leuk Lymphoma 2008;49:2393-2397.
- Ohga S, Nakamura K, Shioyama Y, et al: Radiotherapy for early-stage primary ocular adnexal mucosa-associated lymphoid tissue lymphoma. Anticancer Res 2013;33:5575-5578.
- Harada K, Murakami N, Kitaguchi M, et al: Localized ocular adnexal mucosa-associated lymphoid tissue lymphoma treated with radiation therapy: a long-term outcome in 86 patients with 104 treated eyes. Int J Radiat Oncol Biol Phys 2014;88:650-654.
- Tsang RW, Gospodarowicz MK, Pintilie M, et al: Localized mucosa-associated lymphoid tissue lymphoma treated with radiation therapy has excellent clinical outcome. J Clin Oncol 2003;21:4157-4164.
- Smitt MC, Donaldson SS: Radiotherapy is successful treatment for orbital lymphoma. Int J Radiat Oncol Biol Phys 1993;26:59-66.
- Goda JS, Le LW, Lapperriere NJ, et al: Localized orbital mucosa-associated lymphoma tissue lymphoma managed with primary radiation therapy: efficacy and toxicity. Int J Radiat Oncol Biol Phys 2011;81:e659-e666.
- Stafford SL, Kozelsky TF, Garrity JA, et al: Orbital lymphoma: radiotherapy outcome and complications. Radiother Oncol 2001;59:139-144.
- Lowry L, Smith P, Qian W, et al: Reduced dose radiotherapy for local control in non-Hodgkin lymphoma: a randomised phase III trial. Radiother Oncol 2011;100:86-92.
- Yahalom J, Illidge T, Specht L, et al: Modern radiation therapy for extranodal lymphomas: field and dose guidelines from the International Lymphoma Radiation Oncology Group. Int J Radiat Oncol Biol Phys 2015;92:11-31.
- Galieni P, Polito E, Leccisotti A, et al: Localized orbital lymphoma. Haematologica 1997;82:436-439.
- Baldini L, Blini M, Guffanti A, et al: Treatment and prognosis in a series of primary extranodal lymphomas of the ocular adnexa. Ann Oncol 1998;9:779-781.
- Hasegawa M, Kojima M, Shioya M, et al: Treatment results of radiotherapy for malignant lymphoma of the orbit and histopathologic review according to the WHO classification. Int J Radiat Oncol Biol Phys 2003;57:172-176.
- Matsuo T, Yoshino T: Long-term follow-up results of observation or radiation for conjunctival malignant lymphoma. Ophthalmology 2004;111:1233-1237.
- Uno T, Isobe K, Shikama N, et al: Radiotherapy for extranodal, marginal zone, B-cell lymphoma of mucosa-associated lymphoid tissue originating in the ocular adnexa: a multiinstitutional, retrospective review of 50 patients. Cancer 2003;98:865-871.
- Ejima Y, Sasaki R, Okamoto Y, et al: Ocular adnexal mucosa-associated lymphoid tissue lymphoma treated with radiotherapy. Radiother Oncol 2006;78:6-9.
- Suh CO, Shim SJ, Lee SW, Yang WI, Lee SY, Hahn JS: Orbital marginal zone B-cell lymphoma of MALT: radiotherapy results and clinical behavior. Int J Radiat Oncol Biol Phys 2006;65:228-233.
- Monzen Y, Hasebe H: Radiotherapy for localized orbital mucosa-associated lymphoid tissue lymphoma. Ophthalmologica 2007;221:233-237.
- Nam H, Ahn YC, Kim YD, Ko Y, Kim WS: Prognostic significance of anatomic subsites: results of radiation therapy for 66 patients with localized orbital marginal zone B cell lymphoma. Radiother Oncol 2009;90:236-241.
- Goda JS, Gospodarowicz M, Pintilie M, et al: Long-term outcome in localized extranodal mucosa-associated lymphoid tissue lymphomas treated with radiotherapy. Cancer 2010;116:3815-3824.
- Son SH, Choi BO, Kim GW, et al: Primary radiation therapy in patients with localized orbital marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma). Int J Radiat Oncol Biol Phys 2010;77:86-91.
- Bayraktar S, Bayraktar UD, Stefanovic A, Lossos IS: Primary ocular adnexal mucosa-associated lymphoid tissue lymphoma (MALT): single institution experience in a large cohort of patients. Br J Haematol 2011;152:72-80.
- Hata M, Omura M, Koike I, et al: Treatment effects and sequelae of radiation therapy for orbital mucosa-associated lymphoid tissue lymphoma. Int J Radiat Oncol Biol Phys 2011;81:1387-1393.
- Paik JS, Cho WK, Lee SE, et al: Ophthalmologic outcomes after chemotherapy and/or radiotherapy in non-conjunctival ocular adnexal MALT lymphoma. Ann Hematol 2012;91:1393-1401.
- Haas RL, Poortmans P, de Jong D, et al: High response rates and lasting remissions after low-dose involved field radiotherapy in indolent lymphomas. J Clin Oncol 2003;21:2474-2480.
- Hoskin PJ, Kirkwood AA, Popova B, et al: 4 Gy versus 24 Gy radiotherapy for patients with indolent lymphoma (FORT): a randomised phase 3 non-inferiority trial. Lancet Oncol 2014;15:457-463.
- Kaushik M, Pulido JS, Schild SE, Stafford S: Risk of radiation retinopathy in patients with orbital and ocular lymphoma. Int J Radiat Oncol Biol Phys 2012;84:1145-1150.
- Emami B, Lyman J, Brown A, et al: Tolerance of normal tissue to therapeutic irradiation. Int J Radiat Oncol Biol Phys 1991;21:109-122.
- Goyal S, Cohler A, Camporeale J, Narra V, Yue NJ: Intensity-modulated radiation therapy for orbital lymphoma. Radiat Med 2008;26:573-581.
Article / Publication Details
Copyright / Drug Dosage / DisclaimerCopyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.