CONTACT X-RAY IN THE TREATMENT OF T1 T2-L ESS-THAN-3 CM EYELID CARCINOMAS

Purpose Analysis of a series of 50 patients treated by contact x-ray f or an eyelid carcinoma. Methods From 1980 to 1991, a series of 50 pati ents with 52 lesions has been included in a protocol of contact x ray for eyelid carcinoma. Median age : 69 years; male : 25; female : 25. H istological or cytological diagnosis showed : basocell carcinoma : 47; squamous cell carcinoma : 5. The site was: lower eyelid : 31, inner ca nther: 10; outer canther : 5; upper eyelid: 6. Stade was (UICC 1987): T1 (less than or equal to 2 cm): 44; post excision : 8.Treatment was p erformed on an ambulatory basis with the PHILIPS RT 50 x-ray contact m achine (50 KV - 0.5 mm A1). The diameter of the localized was 10 mm: 2 2; 15 or 20 mm: 30. The standard treatment delivered 42 Gy/7 fractions /4 weeks (1 or 2 fractions of 6 Gy for week). Results There was no dea th due to cancer. A complete response was seen 2 months after the end of treatment in 43/44 cases. A long-term local control was obtained in 47 patients. Loss of eyelash was seen in the irradiated area with a s upple and Mo necroses of the tarsal cartilage. The irradiated skin is slightly depigmented. Stenoses of the lower lacrimal duct is unusual a nd was seen only if it was in the field of irradiation. No cataract wa s observed. The cosmetic and functional results appeared excellent in the large majority of patients. One local relapse occurred in the irra diated area and two just outside the irradiated area. These 3 relapses were salvaged two by surgical excision and one by a subsequent irradi ation. Conclusion Contact x-ray is a simple technique which requires n o hospitalization, neither general anesthesia. It gives excellent loca l control and good cosmetic results in these small eyelid carcinomas.