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  • Partial-orbit radiotherapy is a potential treatment option for orbital MALToma

    Ocular Pathology/Oncology, Oculoplastics/Orbit

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    Review of: Feasibility of partial-orbit irradiation as a treatment strategy for patients with orbital mucosa-associated lymphoid tissue lymphoma

    Chung S, Kook K, Oh Y-T. Canadian Journal of Ophthalmology, in press 2023

    Partial-orbit radiation may provide effective treatment for orbital mucosa-associated lymphoid tissue lymphoma (MALToma) without the high doses of radiation seen with other radiotherapy (RT) technologies.

    Study design

    South Korean investigators conducted a retrospective review of charts from 40 patients with orbital MALToma treated with RT. Patients were divided into 3 groups according to RT field: conjunctival; partial-orbit; or whole-orbit. Partial-orbit clinical target volume was defined as the gross tumor volume plus a 3-mm margin, with the planning target volume defined as the clinical target plus a 5-mm margin.

    Outcomes

    The median treatment dose was 30 Gy, with a median fractional dose of 2 Gy. Local relapse occurred in 2 patients in the conjunctival RT group after complete response but did not occur in any patients in the partial-orbit or whole-orbit groups. Contralateral orbital relapse occurred in 1 patient from the conjunctival group and 1 from the whole-orbit group. There were no deaths or severe acute toxicity events requiring hospital admission or surgery. Regarding dosimetric values, the partial-orbit group showed significantly lower ipsilateral eyeball and eyelid mean doses than the other 2 groups, as well as significantly lower maximum doses in the ipsilateral-orbit and ipsilateral-optic nerve than the whole-orbit group (but not the conjunctival group).

    Limitations

    While this is the first study on orbital MALToma to report and compare the dosimetric values for orbital structures according to treatment fields, it is retrospective with a relatively small sample size.

    Clinical significance

    As a result of the expected long-term survival for patients with MALToma, there is an increasing emphasis on their quality of life. Given the positive outcomes and dosimetric values of partial-orbit radiation, along with its low toxicity, it may therefore be a potential treatment option.

    Financial Disclosures: Dr. Nikisha Richards discloses a financial relationship with Horizon Therapeutics (Consultant/Advisor).