Irradiation treatment of metastatic tumors and lymphomas

Abstract

AbstractIntraocular metastases are usually uveal, secondary to breast or lung carcinoma. Lymphoma is most frequently vitreoretinal, in a context of primary central nervous system lymphoma, while a uveal location points towards systemic lymphoma. Management is influenced by a palliative context and bilateral ocular involvement. Close collaboration with the oncologist is required as to the histopathology of the primary tumor, its global extent, oncologic treatment strategy and life expectancy. Stereotactic irradiation is often the principal ocular treatment. A circumscribed treatment of individual lesions carries the risk of local recurrences. The hemato‐ocular barrier often prevents chemotherapy from being effective within the uvea. Radiotherapy usually allows a quick reattachment of the retina and preservation of vision. Evolution towards a painful globe and enucleation should be avoided. With the increasing life expectancy of oncologic patients, treatment of ischemic retina with anti‐VEGFs and PRP becomes more indicated. Conclusion: Irradiation of intraocular metastases and lymphomas is the most important tool in preserving vision and the eye(s). Its indication should be made within a global oncologic treatment strategy.