RADIOTHERAPY FOR NASOLACRIMAL TRACT EPITHELIAL CANCER

Purpose: Tumors of the lacrimal sac are rare and have traditionally be en treated surgically. We investigated the use of irradiation for trea tment. Methods and Materials: Three consecutive patients with primary epithelial cancer of the nasolacrimal apparatus were treated with irra diation. A tumor dose of 52-66 Gy was delivered with conventional frac tionation to fields limited to the primary site and immediately surrou nding tissues. Results: Local tumor control was achieved in all three patients. Two patients subsequently developed metastatic cervical aden opathy; both were controlled with irradiation to the neck. One of thes e two died of distant metastases. Two patients are alive and well at 1 3 years and at 26 months. Conclusion: We conclude that epithelial lacr imal sac tumors are controllable by radiation therapy and with a good cosmetic result. Poorly differentiated lesions require elective cervic al nodal irradiation.