AN ADJUVANT AFTERLOADING BRACHYTHERAPY DEVICE FOR USE AFTER ORBITAL EXENTERATION IN PATIENTS WITH ORBITAL MALIGNANCIES

In cases of malignant diseases situated within the orbit and threaten to extend beyond it, removal of the orbit and periorbital contents may be indicated followed by adjuvant chemotherapy or irradiation, An eff ective radiotherapy device for treatment of residual or suspicious can cer in the enucleated orbit consists of an external-beam radiation sou rce (Co-60) and an intraoperatively fitted mould as a guide for the fl exible afterloading tubes using a Ir source, Considering the physical dose distribution and the local situation, this therapy permits a high dose with homogeneous dose distribution to the target area of the orb it but also allows significant dose reduction to adjunctive critical s tructures. Four patients with different orbital malignancies were trea ted by means of a combination of percutaneous radiotherapy with afterl oading brachytherapy following orbital exenteration. The individual mo uld of the orbital cavity is modeled at the end of the operation. The technique of radiotherapy, dose distribution, and follow-up of the dis ease are demonstrated. Orbital malignancies with an extremely poor pro gnosis may profit from the application of this combined radiotherapy t o avoid supraradical surgical intervention.