RADIATION-THERAPY FOR STAGE-I PRIMARY ORBITAL NON-HODGKINS-LYMPHOMAS

Aims and Backaround: The orbit is an uncommon primary site for non-Hod gkin's lymphomas (NHL), and it accounts for less than 1% of all sites of primary presentations. We report the experience of the Department o f Radiation Oncology at Ankara University Faculty of Medicine with rad iation therapy in treatment of patients with stage 1 primary orbital N HL. Methods: From February 1978 through August 1993, 14 patients with stage I primary orbital NHL were treated with radiation therapy. Accor ding to the Working Formulation classification, 8 patients had low-gra de and 6 had intermediate-grade lymphomas. The most commonly used radi ation therapy technique was a single anterior field with a Cobalt-60 u nit, delivering 40 Gy in 2 Gy daily fractions. Two patients with inter mediate-grade lymphomas received the CHOP regimen following radiation therapy. Results: Follow-up ranged from 0.8 to 18.3 years (median, 10. 3 years). Local control was achieved in all patients. Two patients wit h low-grade lymphomas relapsed locally and were successfully salvaged with radiation therapy. Three patients with intermediate-grade lymphom as failed systemically. Salvage therapy consisted of combination chemo therapy for 2 of them but was unsuccessful. Overall survival probabili ties at 2, 5 and 10 years were 78.6%, 61.1% and 52.4%, respectively, f or the entire group of 14 patients. Overall, cause-specific and diseas e-free survival probabilities were higher for patients with low-grade lymphomas than for those with intermediate-grade lymphomas (P = 0.03, P = 0.03 and P = 0.06, respectively). Cataracts were observed in 9 and lacrimal disorders in 4 patients. Conclusions: The study suggests tha t among stage I primary orbital NHL, low-grade lymphomas could be trea ted with radiation therapy alone, whereas combination chemotherapy cou ld accompany radiation therapy for intermediate-grade lymphomas.