Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan.
Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan.
Int J Radiat Oncol Biol Phys. 2014 Mar 1;88(3):650-4. doi: 10.1016/j.ijrobp.2013.11.235.
To evaluate the natural history, behavior of progression, prognostic factors, and treatment-related adverse effects of primary ocular adnexal mucosa-associated lymphoid tissue (MALT) lymphoma (POAML).
Eighty-six patients with histologically proven stage I POAML treated with radiation therapy at National Cancer Center Hospital, Tokyo between 1990 and 2010 were retrospectively reviewed. The median age was 56 years (range, 18-85 years). The median dose administered was 30 Gy (range, 30-46 Gy). Seventy-seven patients (90%) were treated by radiation therapy alone.
The median follow-up duration was 9 years (range, 0.9-22 years). The 5- and 10-year overall survival (OS) rates were 97.6% and 93.5%, respectively, and no patients died of lymphoma. Patients with tumor sizes ≥4 cm showed a greater risk of contralateral relapse (P=.012). Six patients with contralateral relapse were seen and treated by radiation therapy alone, and all the lesions were controlled well, with follow-up times of 3 to 12 years. There was 1 case of local relapse after radiation therapy alone, and 3 cases of relapse occurred in a distant site. Cataracts developed in 36 of the 65 eyes treated without lens shielding and in 12 of the 39 patients with lens shielding (P=.037).
The majority of patients with POAML showed behavior consistent with that of localized, indolent diseases. Thirty gray of local irradiation seems to be quite effective. The initial bilateral involvement and contralateral orbital relapses can be also controlled with radiation therapy alone. Lens shielding reduces the risk of cataract.
评估原发性眼附属器黏膜相关淋巴组织（MALT）淋巴瘤（POAML）的自然病史、进展行为、预后因素和与治疗相关的不良反应。
回顾性分析了 1990 年至 2010 年在日本国家癌症中心医院接受放射治疗的 86 例经组织学证实的 I 期 POAML 患者。中位年龄为 56 岁（范围 18-85 岁）。给予的中位剂量为 30Gy（范围 30-46Gy）。77 例（90%）患者单独接受放射治疗。
中位随访时间为 9 年（范围 0.9-22 年）。5 年和 10 年总生存率（OS）分别为 97.6%和 93.5%，无患者死于淋巴瘤。肿瘤大小≥4cm 的患者对侧复发风险更高（P=.012）。有 6 例对侧复发患者，单独接受放射治疗，所有病变均得到良好控制，随访时间为 3 至 12 年。单独放射治疗后有 1 例局部复发，3 例远处部位复发。36 只未行晶状体屏蔽治疗的眼和 39 例行晶状体屏蔽治疗的患者中有 12 例发生白内障（P=.037）。
大多数 POAML 患者的表现符合局限性、惰性疾病。30Gy 的局部照射似乎非常有效。初始双侧受累和对侧眼眶复发也可以单独用放射治疗控制。晶状体屏蔽可降低白内障的风险。
