Hoffmann Christian, Ringbaek Toke, Eckstein Anja, Deya Wolfgang, Santiago Alina, Heintz Martin, Lübcke Wolfgang, Indenkämpen Frank, Sauerwein Wolfgang, Flühs Andrea, Le Guin Claudia, Huettmann Andreas, von Tresckow Julia, Göricke Sophia, Deuschl Cornelius, Moliavi Sourour, Poettgen Christoph, Gauler Thomas, Guberina Nika, Johansson Patricia, Bechrakis Nikolaos, Stuschke Martin, Guberina Maja
Department of Radiotherapy, West German Cancer Centre, University Hospital Essen, 45147 Essen, Germany.
National Center for Tumor Diseases (NCT) West, Campus Essen, 45147 Essen, Germany.
Cancers (Basel). 2023 Nov 15;15(22):5433. doi: 10.3390/cancers15225433.
Irradiation with electrons is the primary treatment regime for localized conjunctival low-grade lymphomas. However, radiation-induced cataracts are a major cause of treatment-related morbidity. This study investigates whether lens-sparing electron irradiation produces sufficient disease control rates while preventing cataract formation. All consecutive patients with strictly conjunctival, low-grade Ann Arbor stage IE lymphoma treated with superficial electron irradiation between 1999 and 2021 at our department were reviewed. A total of 56 patients with 65 treated eyes were enrolled with a median follow-up of 65 months. The median dose was 30.96 Gy. A lens-spearing technique featuring a hanging rod blocking the central beam axis was used in 89.2% of all cases. Cumulative incidences of 5- and 10-year infield recurrences were 4.3% and 14.6%, incidences of 5- and 10-year outfield progression were 10.4% and 13.4%. We used patients with involvement of retroorbital structures treated with whole-orbit photon irradiation without lens protection-of which we reported in a previous study-as a control group. The cumulative cataract incidence for patients treated with electrons and lens protection was significantly lower ( = 0.005) when compared to patients irradiated without lens protection. Thus, electrons are an effective treatment option for conjunctival low-grade lymphomas. The presented lens-sparing technique effectively prevents cataract formation.
电子束照射是局限性结膜低度淋巴瘤的主要治疗方式。然而,辐射诱发的白内障是治疗相关发病的主要原因。本研究调查了保留晶状体的电子束照射在预防白内障形成的同时是否能产生足够的疾病控制率。回顾了1999年至2021年期间在我科接受浅表电子束照射治疗的所有连续性、严格局限于结膜的Ann Arbor分期IE期低度淋巴瘤患者。共纳入56例患者的65只眼,中位随访时间为65个月。中位剂量为30.96 Gy。89.2%的病例采用了一种以悬挂杆阻挡中心束轴为特点的晶状体保留技术。5年和10年内野复发的累积发生率分别为4.3%和14.6%,5年和10年外野进展的发生率分别为10.4%和13.4%。我们将先前研究中报道的、接受全眼眶光子照射且未进行晶状体保护的眶后结构受累患者作为对照组。与未进行晶状体保护的照射患者相比,接受电子束照射并进行晶状体保护的患者白内障累积发生率显著更低(P = 0.005)。因此,电子束是结膜低度淋巴瘤的一种有效治疗选择。所提出的晶状体保留技术能有效预防白内障形成。