Scientific letter
Orbit lymphomas in Spanish population. Descriptive study and side effects of treatment with radiotherapy
Linfomas orbitarios en población española. Estudio descriptivo y efectos secundarios del tratamiento con radioterapia
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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" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Maravillas" "apellidos" => "Abia-Serrano" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Nuria" "apellidos" => "Ibáñez-Flores" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "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" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Actuarial survival curve.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">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"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">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.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The doses used in the patients requiring treatment with radiotherapy were 28–40<span class="elsevierStyleHsp" style=""></span>Gy; eye protectors were used in all cases.</p><p id="par0020" class="elsevierStylePara elsevierViewall">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.</p><p id="par0025" class="elsevierStylePara elsevierViewall">The most frequent subtype was <span class="elsevierStyleItalic">mucosa-associated lymphatic tissue</span> (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.</p><p id="par0030" class="elsevierStylePara elsevierViewall">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.</p><p id="par0035" class="elsevierStylePara elsevierViewall">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.</p><p id="par0040" class="elsevierStylePara elsevierViewall">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.</p><p id="par0045" class="elsevierStylePara elsevierViewall">The only case of plasmacytic lymphoma (3%) occurred at age 51 in stage IE and reached complete remission after treatment.</p><p id="par0050" class="elsevierStylePara elsevierViewall">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.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">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.</p><p id="par0060" class="elsevierStylePara elsevierViewall">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"><span class="elsevierStyleSup">2</span></a> and much lower than that of other European series (80.9%).<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">Radiotherapy was administered with total doses of 28–40<span class="elsevierStyleHsp" style=""></span>Gy; recent studies have shown that doses higher than 40<span class="elsevierStyleHsp" style=""></span>Gy do not improve the percentage of disease control and increase the frequency of side effects, and doses below 30<span class="elsevierStyleHsp" style=""></span>Gy increase the risk of disease recurrence.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">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"><span class="elsevierStyleSup">1</span></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.</p><p id="par0075" class="elsevierStylePara elsevierViewall">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"><span class="elsevierStyleSup">5</span></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.</p><p id="par0080" class="elsevierStylePara elsevierViewall">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.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">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. Med Clin (Barc). 2017;149:36–37.</p>" ] ] "multimedia" => array:1 [ 0 => 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" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Actuarial survival curve.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Orbital lymphoma: role of radiation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "B.S. Yadav" 1 => "S.C. 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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" => "<p id="par0085" class="elsevierStylePara elsevierViewall">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.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000014900000001/v1_201707230028/S2387020617303960/v1_201707230028/en/main.assets" "Apartado" => array:4 [ "identificador" => "43311" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Scientific letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000014900000001/v1_201707230028/S2387020617303960/v1_201707230028/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020617303960?idApp=UINPBA00004N" ]
