학술논문
Long-Term Follow-Up of Patients with Conjunctival Lymphoma after Individualized Lens-Sparing Electron Radiotherapy: Results from a Longitudinal Study.
Document Type
Article
Author
Hoffmann, Christian; Ringbaek, Toke; Eckstein, Anja; Deya, Wolfgang; Santiago, Alina; Heintz, Martin; Lübcke, Wolfgang; Indenkämpen, Frank; Sauerwein, Wolfgang; Flühs, Andrea; Le Guin, Claudia; Huettmann, Andreas; von Tresckow, Julia; Göricke, Sophia; Deuschl, Cornelius; Moliavi, Sourour; Poettgen, Christoph; Gauler, Thomas; Guberina, Nika; Johansson, Patricia
Source
Subject
*CATARACT
*ELECTRONS
*CONFIDENCE intervals
*OCULAR tumors
*RETROSPECTIVE studies
*CANCER patients
*T-test (Statistics)
*KAPLAN-Meier estimator
*DESCRIPTIVE statistics
*LYMPHOMAS
*RADIOTHERAPY
*DATA analysis software
*PROGRESSION-free survival
*CRYSTALLINE lens
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Language
ISSN
2072-6694
Abstract
Simple Summary: This study investigates whether lens-sparing electron irradiation of low-grade, conjunctival lymphomas prevents cataract formation while ensuring high disease control rates. This study presents the data of 65 eyes of 56 patients with low-grade Ann Arbor stage I conjunctival lymphomas that were treated with either lens-sparing or non-lens-sparing electron irradiation. After a median follow-up of 65 months, the cumulative incidences of 5- and 10-year outfield progression were 10.4% and 13.4% while the cataract incidence was significantly lower in patients treated with a lens-shielding technique. The presented data underline the status of radiotherapy as first line therapy for low-grade conjunctival lymphomas. Irradiation with electrons is the primary treatment regime for localized conjunctival low-grade lymphomas. However, radiation-induced cataracts are a major cause of treatment-related morbidity. This study investigates whether lens-sparing electron irradiation produces sufficient disease control rates while preventing cataract formation. All consecutive patients with strictly conjunctival, low-grade Ann Arbor stage IE lymphoma treated with superficial electron irradiation between 1999 and 2021 at our department were reviewed. A total of 56 patients with 65 treated eyes were enrolled with a median follow-up of 65 months. The median dose was 30.96 Gy. A lens-spearing technique featuring a hanging rod blocking the central beam axis was used in 89.2% of all cases. Cumulative incidences of 5- and 10-year infield recurrences were 4.3% and 14.6%, incidences of 5- and 10-year outfield progression were 10.4% and 13.4%. We used patients with involvement of retroorbital structures treated with whole-orbit photon irradiation without lens protection—of which we reported in a previous study—as a control group. The cumulative cataract incidence for patients treated with electrons and lens protection was significantly lower (p = 0.005) when compared to patients irradiated without lens protection. Thus, electrons are an effective treatment option for conjunctival low-grade lymphomas. The presented lens-sparing technique effectively prevents cataract formation. [ABSTRACT FROM AUTHOR]