Outcomes of orbital malignancies treated with eye-sparing surgery and adjuvant particle radiotherapy: a retrospective study

Weixu Hu,Xianxin Qiu,Jing Yang,Lin Kong,Jing Gao,Jiade J Lu,Jiyi Hu

doi:10.1186/s12885-019-5964-y

Abstract

BackgroundTo report the clinical experience of eye sparing surgery (ESS) and adjuvant carbon-ion or proton radiotherapy (CIRT or PRT) for orbital malignancies.MethodsAn analysis of the retrospective data registry from the Shanghai Proton and Heavy Ion Center for patients with orbital tumors was conducted. The 2-year local progression-free, regional recurrence-free, distant metastasis-free, progression-free, and overall survival (LPFS, RRFS, DMFS, PFS, OS) rates as well as associated prognostic indicators were analyzed. Radiotherapy-induced acute and late toxicities were summarized.ResultsBetween 7/2014 to 5/2018, 22 patients with orbital malignancies of various pathologies received ESS followed by CIRT (18), PRT (1), or PRT + CIRT boost (3). With a median follow-up of 20.25 (range 3.8–38.8) months, the 2-year OS, PFS, LPFS, RRFS, and DMFS rates were 100, 57.9, 92.9, 93.3, and 72.8%, respectively. No acute severe (i.e., ≥grade 3) toxicity was observed. Two patients experienced severe visual impairment as late toxicities.ConclusionWith few observed acute and late toxicities, particle radiotherapy following ESS provided effective local control with infrequent severe toxicities for patients with orbital malignancies.

Highlights

To report the clinical experience of eye sparing surgery (ESS) and adjuvant carbon-ion or proton radiotherapy (CIRT or PRT) for orbital malignancies
Orbital tumors are relatively rare with an incidence of 3.4/106 person-years [1]; its management poses a major challenge to oncologists due to the complexities in the pathologies of the tumors and their proximity to the critical organs at risk (OARs)
We report the outcomes in terms of efficacy and safety of a group of patients with orbital tumors treated with adjuvant particle radiotherapy after ESS

Summary

Introduction

To report the clinical experience of eye sparing surgery (ESS) and adjuvant carbon-ion or proton radiotherapy (CIRT or PRT) for orbital malignancies. Eye-sparing surgery (ESS) is the current preferred primary treatment for most types of neoplasm of epithelial or mesenchymal origin [2]; sufficient margins are difficult to achieve especially for locally advanced diseases. Limited resection poses a high risk of local recurrence. Multidisciplinary approach including surgery followed by adjuvant radiotherapy or chemoradiation is usually needed for orbital malignancies. Lower doses are usually insufficient for controlling the more commonly diagnosed orbital malignancies including squamous cell carcinoma, adenoid cystic carcinoma (ACC) and soft-tissue sarcoma (STS) [1, 2, 4,5,6]

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Discussion

Conclusion