Ioakeim-Ioannidou Myrsini, MacDonald Shannon M
Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States.
J Neurol Surg B Skull Base. 2020 Aug;81(4):480-496. doi: 10.1055/s-0040-1713894. Epub 2020 Aug 24.
Orbital tumors are rare lesions comprising 0.1% of all tumors and less than 20% of all ocular diseases. These lesions in children and adults differ significantly in their incidence, tumor type, and treatment management. Although surgery and systemic therapies are commonly used in the management of these diseases, radiation therapy has become a widely used treatment for both benign and malignant tumors of the orbit. Radiotherapy is used as a definitive treatment to provide local control while avoiding morbidity associated with surgery for some tumors while it is used as an adjuvant treatment following surgical resection for others. For many tumors, radiation provides excellent tumor control with preservation of visual function. This article is dedicated for presenting the most common applications of orbital radiotherapy. A brief overview of the commonly available radiation therapy modalities is given. Dose constraint goals are reviewed and acute and long-term side effects are discussed. Orbital tumors covered in this article include optic glioma, ocular melanoma, retinoblastoma, orbital rhabdomyosarcoma, orbital lymphoma, and lacrimal gland tumors. Background information, indications for radiotherapy, and goals of treatment for each case example are described.
眼眶肿瘤是罕见病变,占所有肿瘤的0.1%,在所有眼部疾病中占比不到20%。这些病变在儿童和成人中的发病率、肿瘤类型及治疗管理存在显著差异。尽管手术和全身治疗常用于这些疾病的管理,但放射治疗已成为眼眶良性和恶性肿瘤广泛使用的治疗方法。放射治疗用作根治性治疗以实现局部控制,同时避免某些肿瘤手术相关的发病率,而对其他肿瘤则用作手术切除后的辅助治疗。对于许多肿瘤,放射治疗能在保留视觉功能的情况下实现良好的肿瘤控制。本文致力于介绍眼眶放射治疗的最常见应用。简要概述了常用的放射治疗方式。回顾了剂量限制目标并讨论了急性和长期副作用。本文涵盖的眼眶肿瘤包括视神经胶质瘤、眼黑色素瘤、视网膜母细胞瘤、眼眶横纹肌肉瘤、眼眶淋巴瘤及泪腺肿瘤。描述了每个病例的背景信息、放射治疗适应症及治疗目标。