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[眼眶及眼附属器原发性淋巴瘤的新系统治疗方法]

[New systemic treatment approach for primary lymphoma of the orbit and the ocular adnexa].

作者信息

Niederau Constantin, Wawer Matos Reimer Philomena Alice, Rokohl Alexander, Heindl Ludwig

机构信息

Zentrum für Augenheilkunde, Medizinische Fakultät und Universitätsklinikum Köln, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland.

Centrum für Integrierte Onkologie (CIO) Aachen-Bonn-Köln-Düsseldorf, Köln, Deutschland.

出版信息

Ophthalmologie. 2025 May;122(5):357-364. doi: 10.1007/s00347-024-02169-4. Epub 2025 Jan 14.

Abstract

BACKGROUND

Orbital lymphomas are the most frequently occurring malignant tumor entities in this region. They are less frequently also localized in the ocular adnexa and show a high entity-specific heterogeneity regarding the treatment and prognosis.

OBJECTIVE

This article gives an overview of the heterogeneity of symptoms of orbital lymphoma and lymphoma of the ocular adnexa and focuses on new systemic options for treatment of this disease.

MATERIAL AND METHODS

For this article a systematic search of the PubMed databank was carried out and the practical knowledge of the authors was taken into account.

RESULTS AND CONCLUSION

Orbital lymphoma and lymphoma of the ocular adnexa show a high variability in the clinical symptoms and therefore require a comprehensive ophthalmological examination of the affected patients. Histopathologically assisted diagnostics after an incisional biopsy are essential for the classification into the various lymphoma entities. This is necessary for developing and carrying out a targeted treatment concept consisting of local and systemic treatment modalities. Especially for the new systemic treatment approaches, in addition to the histopathological classification of the lymphoma entity it is also necessary to analyze the molecular features in order to efficiently implement the new highly specific medications. Finally, a close interdisciplinary cooperation of all disciplines involved is absolutely necessary for the best possible treatment, including ophthalmology, hemato-oncology, radiotherapy, radiology, pathology and psycho-oncology. Depending on the localization of the tumor, inclusion of otorhinolaryngology, oral and maxillofacial surgery and/or neurosurgery can be necessary.

摘要

背景

眼眶淋巴瘤是该区域最常见的恶性肿瘤类型。它们较少发生于眼附属器,并且在治疗和预后方面表现出高度的病种特异性异质性。

目的

本文概述眼眶淋巴瘤和眼附属器淋巴瘤症状的异质性,并重点介绍该疾病的新的全身治疗选择。

材料与方法

本文对PubMed数据库进行了系统检索,并参考了作者的实践知识。

结果与结论

眼眶淋巴瘤和眼附属器淋巴瘤的临床症状具有高度变异性,因此需要对受影响的患者进行全面的眼科检查。切开活检后在组织病理学辅助下的诊断对于将其分类为各种淋巴瘤类型至关重要。这对于制定和实施由局部和全身治疗方式组成的靶向治疗方案是必要的。特别是对于新的全身治疗方法,除了淋巴瘤类型的组织病理学分类外,还需要分析分子特征,以便有效地应用新的高度特异性药物。最后,为了实现最佳治疗,所有相关学科之间密切的跨学科合作绝对必要,包括眼科、血液肿瘤学、放射治疗、放射学、病理学和心理肿瘤学。根据肿瘤的定位,可能需要耳鼻喉科、口腔颌面外科和/或神经外科的参与。

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