Orbit lymphomas in Spanish population. Descriptive study and side effects of treatment with radiotherapy

Cifuentes-Canorea, Pilar; Abia-Serrano, Maravillas; Ibáñez-Flores, Nuria

doi:10.1016/j.medcle.2017.06.008

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Descriptive study and side effects of treatment with radiotherapy" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "36" "paginaFinal" => "37" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Pilar Cifuentes-Canorea, Maravillas Abia-Serrano, Nuria Ibáñez-Flores" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Pilar" "apellidos" => "Cifuentes-Canorea" "email" => array:1 [ 0 => "pilarcifuca@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Maravillas" "apellidos" => "Abia-Serrano" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Nuria" "apellidos" => "Ibáñez-Flores" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Institut Català de Retina, Barcelona, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Bellvitge University Hospital, Barcelona, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Universitat Internacional de Catalunya, Barcelona, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Linfomas orbitarios en población española. Estudio descriptivo y efectos secundarios del tratamiento con radioterapia" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1233 "Ancho" => 1651 "Tamanyo" => 52344 ] ] "descripcion" => array:1 [ "en" => "Actuarial survival curve." ] ] ] "textoCompleto" => "Currently, radiotherapy as monotherapy in primary orbital lymphomas in Ann Arbor stage IE (involvement of a single extranodal region) is a highly effective treatment in the recovery of these patients. This treatment is a challenge because of the radiosensitivity of the tissues such as the lens, the lacrimal gland and the retina.<a class="elsevierStyleCrossRef" href="#bib0030">1</a>We performed a retrospective study in patients diagnosed with orbital lymphoma in the Ophthalmology services of the Bellvitge Hospital, Catalan Institute of Retina and Teknon Medical Center between 2000 and 2016, according to consensual protocols, all of which were treated in the Radiotherapy Service of the Catalan Institute of Oncology.The doses used in the patients requiring treatment with radiotherapy were 28–40Gy; eye protectors were used in all cases.In total, 35 patients were analyzed, of which 24 were women and 11 were men. The most frequent reason for consultation was the presence of an orbital mass in all subtypes, except for plasmacytic lymphoma, which was due to an epiphora.The most frequent subtype was mucosa-associated lymphatic tissue (MALT) (60%), with a mean age of presentation of 59 years; 72% were in stage IE at the time of diagnosis and 85% presented complete remission throughout the follow-up.The second most frequent was large B-cell lymphoma (17%), with a mean age of presentation of 49 years, 68% in stage IE at the time of diagnosis and 66% of complete remission.The next in frequency was follicular lymphoma (14%), with a mean age of presentation of 67 years, 20% in stage IE at the time of diagnosis and 40% of complete remission.The mean age of presentation for mantle cell lymphoma (6%) was 69 years, 50% were in stage IE at the time of diagnosis and no patient achieved complete remission, 50% of them had partial remission of the disease.The only case of plasmacytic lymphoma (3%) occurred at age 51 in stage IE and reached complete remission after treatment.We next show an actuarial survival curve (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). With a follow-up of between 1 and 16 years, we can observe the low frequency of death, all cases occurring before the third year after diagnosis.<elsevierMultimedia ident="fig0005"></elsevierMultimedia>Of the 35 patients studied, 27 received treatment with local radiotherapy. Only 6 patients had side effects, all of them mild and with a good response to topical medical treatment, such as blepharitis, self-limiting dermatitis, keratitis and nonspecific ocular discomfort.In our study, the most frequent subtype was the MALT type (60%), which is lower than that of other North American series (64%)<a class="elsevierStyleCrossRef" href="#bib0035">2</a> and much lower than that of other European series (80.9%).<a class="elsevierStyleCrossRef" href="#bib0040">3</a>Radiotherapy was administered with total doses of 28–40Gy; recent studies have shown that doses higher than 40Gy do not improve the percentage of disease control and increase the frequency of side effects, and doses below 30Gy increase the risk of disease recurrence.<a class="elsevierStyleCrossRef" href="#bib0045">4</a>No patient developed cataracts throughout the follow-up, probably due to the use of eye protectors. In the review published by Yadav and Sharma,<a class="elsevierStyleCrossRef" href="#bib0030">1</a> an incidence of 0–38% was found in the studies in which eye protectors were used and between 9 and 100% in those that did not use them.Analyzing the MALT subtype, we observed a percentage of complete remission (local and systemic) with radiotherapy in 85%; other studies describe higher percentages (97%).<a class="elsevierStyleCrossRef" href="#bib0050">5</a> This difference is probably due to the fact that these studies analyze, on the one hand, local control, and on the other, the occurrence of disease in other locations.In conclusion, in the Spanish population studied, orbital lymphomas appear more frequently as an orbital mass in women and in ages around 60, the most frequent subtype is MALT and, in case of localized disease, radiotherapy with the use of eye protectors obtains excellent disease control with very mild side effects and with good response to conservative treatment." "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Cifuentes-Canorea P, Abia-Serrano M, Ibáñez-Flores N. Linfomas orbitarios en población española. Estudio descriptivo y efectos secundarios del tratamiento con radioterapia. 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Sharma" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Indian J Ophthalmol" "fecha" => "2009" "volumen" => "57" "paginaInicial" => "91" "paginaFinal" => "97" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19237780" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lymphoproliferative lesions of the ocular adnexa. Analysis of 112 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S.E. Coupland" 1 => "L. Krause" 2 => "H.J. Delecluse" 3 => "I. Anagnostopoulos" 4 => "H.D. Foss" 5 => "M. Hummel" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0161-6420(98)98024-1" "Revista" => array:6 [ "tituloSerie" => "Ophthalmology" "fecha" => "1998" "volumen" => "105" "paginaInicial" => "1430" "paginaFinal" => "1441" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9709754" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0040" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Radiation therapy in primary orbital lymphoma: a single institution retrospective analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L. De Cicco" 1 => "L. Cella" 2 => "R. Liuzzi" 3 => "R. Solla" 4 => "A. Farella" 5 => "G. Punzo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/1748-717X-7-60" "Revista" => array:5 [ "tituloSerie" => "Radiat Oncol" "fecha" => "2009" "volumen" => "7" "paginaInicial" => "60" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22501022" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0045" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical stage IEA-IIEA orbital lymphomas: outcomes in the era of modern staging and treatment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "C.E. Pelloski" 1 => "R.B. Wilder" 2 => "C.S. Ha" 3 => "M.A. Hess" 4 => "F.F. Cabanillas" 5 => "J.D. Cox" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Radiother Oncol" "fecha" => "2001" "volumen" => "59" "paginaInicial" => "145" "paginaFinal" => "151" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11325442" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0050" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Outcome and prognostic factors in orbital lymphoma: a Rare Cancer Network study on 90 consecutive patients treated with radiotherapy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Martinet" 1 => "M. Ozsahin" 2 => "Y. Belkacémi" 3 => "C. Landmann" 4 => "P. Poortmans" 5 => "C. Oehlere" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Int J Radiat Oncol Biol Phys" "fecha" => "2003" "volumen" => "55" "paginaInicial" => "892" "paginaFinal" => "898" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12605966" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack290987" "titulo" => "Acknowledgements" "texto" => "We would like to thank Dr. Ferran Mascaró, Bellvitge Hospital and Teknon Medical Center, Dr. Vanesa Cuadrado, of the Catalan Institute of Retina, and Dr. Ramón Rodríguez, Bellvitge Hospital, for his help in the preparation of this work." 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Vol. 149. Issue 1.

Pages 36-37 (July 2017)

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