Radiation therapy for local control of eyelid sebaceous cell carcinoma - Report of two cases and review of the literature

Purpose: Because of previous reports of increased rate of recurrence and mo rtality after radiation therapy, eyelid sebaceous cell carcinoma has been c onsidered radioresistent. Recent reports of success with primary radiation therapy have been attributed to advancements in irradiating technology and technique. Two cases of eyelid sebaceous cell carcinoma successfully treate d with radiation therapy are reported. The techniques used are compared wit h the techniques described in previous reports, and factors favoring succes sful treatment are reevaluated. Methods: Case series and review of the literature. Two cases of eyelid seba ceous cell carcinoma that underwent radiation therapy are described. Both p atients were offered, but refused, surgical excision. One patient received 69 Gy combined superficial and megavoltage x-ray irradiation to the left lo wer eyelid. The second patient received 59 Gy megavoltage electron beam irr adiation to the right upper eyelid. A review of the literature was performe d, and Fisher's exact test analysis was used to compare the results of all reported cases treated with less than or equal to 55 Gy with those treated with >55 Gy. Results: In both cases, the tumor responded to radiation therapy. One patie nt died 39 months after treatment, of myocardial infarction. The second pat ient is without clinical evidence of tumor recurrence 46 months after treat ment. Fisher's exact test showed an advantage to patients treated with >55 Gy radiation (p = 0.05). Conclusion: Radiation therapy with an appropriate delivery system is effect ive as a curative treatment for eyelid sebaceous cell carcinoma when >55 Gy of radiation dose is delivered. It should be considered for patients seeki ng an alternative to surgical excision.