Department of Radiation Oncology, Stanford University, Stanford, California, USA.
Int J Radiat Oncol Biol Phys. 2013 Aug 1;86(5):930-5. doi: 10.1016/j.ijrobp.2013.04.035. Epub 2013 May 29.
Low-dose radiation has become increasingly used in the management of indolent non-Hodgkin lymphoma (NHL), but has not been studied specifically for cases of ocular adnexal involvement. The objective of this study is to investigate the effectiveness of low-dose radiation in the treatment of NHL of the ocular adnexa.
We reviewed the records of 20 NHL patients with 27 sites of ocular adnexal involvement treated with low-dose radiation consisting of 2 successive fractions of 2 Gy at our institution between 2005 and 2011. The primary endpoint of this study is freedom from local relapse (FFLR).
At a median follow-up time of 26 months (range 7-92), the overall response rate for the 27 treated sites was 96%, with a complete response (CR) rate of 85% (n=23) and a partial response rate of 11% (n=3). Among all treated sites with CR, the 2-year FFLR was 100%, with no in-treatment field relapses. The 2-year freedom from regional relapse rate was 96% with 1 case of relapse within the ipsilateral orbit (outside of the treatment field). This patient underwent additional treatment with low-dose radiation of 4 Gy to the area of relapse achieving a CR and no evidence of disease at an additional 42 months of follow-up. Orbital radiation was well tolerated with only mild acute side effects (dry eye, conjunctivitis, transient periorbital edema) in 30% of treated sites without any reports of long-term toxicity.
Low-dose radiation with 2 Gy × 2 is effective and well tolerated in the treatment of indolent NHL of the ocular adnexa with high response rates and durable local control with the option of reirradiation in the case of locoregional relapse.
低剂量辐射在惰性非霍奇金淋巴瘤（NHL）的治疗中应用越来越广泛，但尚未专门针对眼附属器受累病例进行研究。本研究旨在探讨低剂量辐射治疗眼附属器 NHL 的疗效。
我们回顾了 2011 年在我院接受低剂量放疗的 27 处眼附属器受累 NHL 患者的记录，这些患者在 2005 年至 2011 年期间接受了 2 次 2 Gy 的连续分割剂量。本研究的主要终点是无局部复发（FFLR）。
在 26 个月的中位随访时间（范围 7-92 个月）中，27 处治疗部位的总体缓解率为 96%，完全缓解（CR）率为 85%（n=23），部分缓解率为 11%（n=3）。所有获得 CR 的治疗部位中，2 年 FFLR 为 100%，无治疗中野复发。2 年无区域性复发率为 96%，1 例同侧眼眶内复发（治疗野外）。该患者接受了 4 Gy 低剂量放疗，对复发区域进行了额外治疗，获得了 CR，且在额外 42 个月的随访中无疾病证据。30%的治疗部位仅有轻度急性副作用（干眼症、结膜炎、短暂性眶周水肿），没有任何长期毒性报告，因此眶部放疗耐受性良好。
2 Gy×2 的低剂量放疗治疗眼附属器惰性 NHL 有效且耐受性良好，反应率高，局部控制持久，在发生局部区域复发时可选择再放疗。
