Suh Chang-Ok, Shim Su Jung, Lee Sang-Wook, Yang Woo Ick, Lee Sang Yeul, Hahn Jee Sook
Department of Radiation Oncology, Yonsei University College of Medicine, Yonsei Cancer Center, Seoul, Republic of Korea.
Int J Radiat Oncol Biol Phys. 2006 May 1;65(1):228-33. doi: 10.1016/j.ijrobp.2005.11.035. Epub 2006 Feb 28.
To elucidate the clinical behavior and treatment outcome of low-grade primary orbital lymphoma arising from mucosa-associated lymphoid tissue (MALT).
Forty-eight patients with pathologically confirmed marginal zone B-cell lymphoma of MALT were treated with radiotherapy (RT). Thirty-eight patients (79.1%) received thorough staging workup studies including bone marrow biopsy. Radiation doses ranged from 5.4 to 30.6 Gy (median, 30.6 Gy). Median follow-up period was 70 months.
Only 2 patients revealed extraorbital lymphoma involvement (bone marrow, skin). Forty-six of 52 eye lesions showed complete response to RT. Six lesions demonstrated a partial response and showed gradual regression during the follow-up period of 39-72 months. Three patients experienced local recurrences at 34, 48, and 52 months after RT, which seemed to be related to improper use of the lens shield. Salvage re-RT was successful. The 10-year actuarial relapse-free survival, cause-specific survival, and overall survival rates were 93.1%, 97.9%, and 86.9%, respectively.
Most of the MALT lymphoma of the orbit was localized at diagnosis and extraorbital relapse rarely occurred. Therefore, extensive staging workup at the time of diagnosis and follow-up studies to detect distant relapse may not be obligatory. Low-dose RT alone with proper lens shielding is the optimum treatment modality for orbital MALT lymphoma.
阐明源于黏膜相关淋巴组织（MALT）的低度原发性眼眶淋巴瘤的临床行为和治疗结果。
48例经病理证实为MALT边缘区B细胞淋巴瘤的患者接受了放射治疗（RT）。38例患者（79.1%）接受了包括骨髓活检在内的全面分期检查。放射剂量范围为5.4至30.6 Gy（中位数，30.6 Gy）。中位随访期为70个月。
仅2例患者出现眶外淋巴瘤累及（骨髓、皮肤）。52只眼部病变中的46只对RT显示完全缓解。6只病变显示部分缓解，并在39至72个月的随访期内逐渐消退。3例患者在RT后34、48和52个月出现局部复发，这似乎与晶状体防护罩使用不当有关。挽救性再次RT成功。10年精算无复发生存率、病因特异性生存率和总生存率分别为93.1%、97.9%和86.9%。
大多数眼眶MALT淋巴瘤在诊断时局限，很少发生眶外复发。因此，诊断时进行广泛的分期检查和随访研究以检测远处复发可能并非必要。单独使用低剂量RT并适当使用晶状体防护罩是眼眶MALT淋巴瘤的最佳治疗方式。
