Electron therapy for orbital and periorbital lesions using customized lead eye shields

Abstract

Purpose: To establish the protective efficacy against late complications of electron therapy using customized lead eye shields in cases with orbital and periorbital lesions.

Methods: Between 1982 and 2006, 16 patients with 22 orbital and periorbital lesions were treated by electron therapy. Customized lead eye shields were prepared and placed in the respective patients' eyes during each fraction of electron therapy. The toxicity and local control rates were analyzed.

Results: The preparation period for the customized lead eye shields was 2 days. The shields could be used throughout the treatment period in all the patients. No evidence of radiation cataract was observed in 15 of the 16 patients. None of the patients developed corneal ulceration or evidence of lead poisoning.

Conclusion: Customized lead eye shields could be made relatively quickly, and electron therapy for orbital and periorbital lesions could be undertaken safely without any late complication.

Fig. 1.

The preparation of the lead eye shield. a Impression of the eye surface. b Lead eye shield (frontal view). c Lead eye shield (side view).

Fig. 2.

Schema of shielding eye.

Fig. 3.

Central axis dose curve of 4MeV electron. Relative ionization of the surface of the globe was 3.3% when the depth along the beam axis was 7 mm.

Fig. 4.

The 4MeV electron therapy process (35 Gy/14 fr/25 days) in a 26-year-old male with MALT lymphoma. a Lymphoma of the right inner canthus (white arrow). b Application of the lead eye shield during the electron therapy. c Electron therapy in progress. d The tumor vanished by 2.5 years after the electron therapy.