Schultze J, Hinrichs M, Kimmig B
Klinik für Strahlentherapie (Radioonkologie), Klinikum Christian-Albrechts-Universität zu Kiel.
Strahlenther Onkol. 1996 Aug;172(8):417-21.
Aim of the study was the evaluation of the role of adjuvant radiation therapy in the prevention of recurrence after excision.
Between July 1, 1985 and April 1, 1993, 64 patients (43 male, 21 female) were referred to radiation therapy after excision of a nasal pterygium. Radiation therapy was done with a strontium-90 eye applicator and a total dose of 30 Gy, fractionated in 6 fractions of 5 Gy each, 3 times a week. Forty-nine patients were treated primarily, 15 patients underwent radiation therapy for the first time in case of recurrent pterygium after multiple re-excisions. All patients had a following of 1 to 9 years with a median of 5.5 years.
In 8 of 64 irradiated patients recurrent pterygium was detected (12.5%). Differentiated into the 2 groups 4 of the primarily treated patients had recurrent pterygium (8.16%), the other 4 were in the group with multiple former re-excisions (26.7%). With regard to the initiation of the irradiation after surgery pterygium did not recur in any of the primarily treated patients who were irradiated in between 3 days after surgery. In contrary 3 of 7 primarily treated patients (42.9%) who started radiation therapy between 7 and 10 days after surgery had recurrent pterygium. For the patients with primarily recurrent pterygium no dependence of the initiation of radiation therapy after surgery could be detected.
Adjuvant radiation therapy after excision of pterygium lowers the rate of recurrence from about 40% to 12.5%, in a primarily adjuvant situation to 8.16%. In these patients radiation therapy should be initiated within 3 days after surgery. Patients with primarily recurrent pterygium have an elevated risk of recurrence independently of the initiation of radiation therapy.
