Abstract
Orbital lymphoma is rare and accounts for less than 1% of non-Hodgkins lymphomas (NHLs) throughout the body. Marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT) type ise the most common histological type involving the orbit. MALT lymphomas are indolent, and usually respond well to local radiotherapy (RT). Results from RT series demonstrated excellent and durable local control and survival rates in patients with localized orbital MALT lymphoma. However, due to the rarity of the disease, data about optimal radiation dose from comparative studies are not available and, moreover, in reports with a substantial number of treated patients, doses in the range of 20 and 57 Gy were found to be used. The optimal radiation dose for treating this tumor is controversial. This case is presented because of rare incidence of orbital maltoma and to evaluate the effectiveness of RT in our Radiation Oncology department.
Highlights
RT TreatmentPatients head was immobilized with a thermoplastic mask before CT simulation
Immunological phenotyping on parafin sections was performed for demonstration of light chain restriction and the phenotype CD20+, CD5, CD10, CD23, cyclin D1, and ki-67 proliferation index was 5-10%, in context with a microscopic appearance, is consistent with an indication of a mucosa-associated lymphoid tissue (MALT) lymphoma
A series of orbital maltomas reported by Bischof et al [9] showed no local relapse in their 26 stage I patients
Summary
Patients head was immobilized with a thermoplastic mask before CT simulation. The structures at risk (right and left eye, right and left lens, right and left lacrimal gland, right and left optic nerve and optic chiasm) were contoured. The whole orbital socket was included in the Clinical Target Volume (CTV). An isocentric multibeam technique with inverse optimization was used to deliver specified doses to the Planning Target Volume (PTV). The dose was prescribed such that >95% of the PTV received 100% of the prescribed dose. RT delivered 36 Gy at 1.8 Gy per fraction by intensity-modulated radiotherapy (IMRT) technique
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