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. 2017 Jun;39(6):1095-1100.
doi: 10.1002/hed.24717. Epub 2017 Apr 3.

Ultra-low-dose radiotherapy for definitive management of ocular adnexal B-cell lymphoma

Chelsea C Pinnix  1 , Bouthaina S Dabaja  1 , Sarah A Milgrom  1 , Grace L Smith  1 , Zeinab Abou  1 , Loretta Nastoupil  2 , Jorge Romaguera  2 , Francesco Turturro  2 , Nathan Fowler  2 , Luis Fayad  2 , Jason Westin  2 , Sattva Neelapu  2 , Michelle A Fanale  2 , Maria A Rodriguez  2 , Frederick Hagemeister  2 , Hun Ju Lee  2 , Yasuhiro Oki  2 , Michael Wang  2 , Felipe Samaniego  2 , Linda Chi  3 , Bita Esmaeli  4
Affiliations

Ultra-low-dose radiotherapy for definitive management of ocular adnexal B-cell lymphoma

Chelsea C Pinnix et al. Head Neck. 2017 Jun.

Erratum in

  • Ultra-low-dose radiotherapy for definitive management of ocular adnexal B-cell lymphoma.
    Pinnix CC, Dabaja BS, Milgrom SA, Smith GL, Abou Z, Nastoupil L, Romaguera J, Turturro F, Fowler N, Fayad L, Westin J, Neelapu S, Fanale MA, Rodriguez MA, Hagemeister F, Ju Lee H, Oki Y, Wang M, Samaniego F, Chi L, Esmaeli B. Pinnix CC, et al. Head Neck. 2018 Jun;40(6):1335. doi: 10.1002/hed.25149. Epub 2018 Feb 21. Head Neck. 2018. PMID: 29851218 No abstract available.
  • Ultra-low-dose radiotherapy for definitive management of ocular adnexal B-cell lymphoma.
    Pinnix CC, Dabaja BS, Milgrom SA, Smith GL, Abou Yehia Z, Nastoupil L, Romaguera J, Turturro F, Fowler N, Fayad L, Westin J, Neelapu S, Fanale MA, Rodriguez MA, Hagemeister F, Lee HJ, Oki Y, Wang M, Samaniego F, Chi L, Esmaeli B. Pinnix CC, et al. Head Neck. 2019 May;41(5):1546. doi: 10.1002/hed.25738. Epub 2019 Mar 19. Head Neck. 2019. PMID: 30990235 No abstract available.

Abstract

Background: The purpose of this study was to report the response to and toxicity of ultra-low-dose radiotherapy (RT) for B-cell ocular adnexal lymphoma (OAL).

Methods: We conducted a retrospective review of patients with indolent B-cell and mantle cell OAL treated with 4 Gy to the orbit(s) in two 2-Gy fractions. Disease response was assessed clinically and/or radiographically at 2 to 4-month intervals after RT. Data collected included rates of overall response, complete response (CR), partial response (PR), and treatment-related toxic effects.

Results: Twenty-two patients (median age, 65 years) had the following histologic subtypes: mucosa-associated lymphoid tissue (MALT; 14 patients; 64%); follicular lymphoma (5 patients; 23%); mantle cell lymphoma (MCL; 2 patients; 9%); and unclassifiable (1 patient, 4%). The overall response rate was 100%; 19 patients (86%) had a CR and 3 patients (14%) had a PR. The only acute toxic effect was grade 1 dry eye syndrome in 1 patient.

Conclusion: Ultra-low-dose RT in patients with OAL is associated with high response rates and minimal toxic effects, and is much shorter in duration and cost. © 2017 Wiley Periodicals, Inc. Head Neck 39: 1095-1100, 2017.

Keywords: mantle cell lymphoma; mucosa-associated lymphoid tumor; ocular adnexal lymphoma; orbital lymphoma; radiotherapy.

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Figures

FIGURE 1.
FIGURE 1.
Orbital response to 4 Gy orbital radiotherapy (RT) rates of complete response (CR) and partial response (PR) after completion of ultra–low-dose radiotherapy to the orbit. At 4 months, 20 patients were evaluated for disease response and CR was achieved among 65% of patients (n = 13). At 6 months, 21 patients were evaluated and CR was apparent in 86% of patients (n = 19). The 1 patient who was not evaluated at 6 months was seen at 3-month and 6-month follow-ups, and was pending at the time of manuscript preparation of this study. [Color figure can be viewed at wileyonlinelibrary.com]
FIGURE 2.
FIGURE 2.
Complete response to ultra–low-dose orbital radiotherapy (RT) for mantle cell lymphoma (MCL) achieved 10 months after completion of RT. (A) A 70-year-old woman with stage IV MCL had a dominant enhancing left lacrimal gland mass measuring 2.6 × 1.5 cm on axial postcontrast CT imaging. (B) She was treated with 4 Gy in 2 fractions with 16-MeV electrons. (C) She had a partial response to RT at 4 months after completion of RT. (D) She had a complete response to RT at 10.5 months after completion of RT without any interval treatment. [Color figure can be viewed at wileyonlinelibrary.com]
FIGURE 3.
FIGURE 3.
Rate of freedom from local recurrence among patients with ocular adnexal low-grade B-cell lymphoma and mantle cell lymphoma who achieved a complete response after treatment with 4 Gy in 2 fractions (n = 5 19). [Color figure can be viewed at wileyonlinelibrary.com]
See this image and copyright information in PMC

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