A Multidisciplinary Orbit-Sparing Treatment Approach That Includes Proton Therapy for Epithelial Tumors of the Orbit and Ocular Adnexa.

摘要: Purpose Postoperative radiation is often indicated in the treatment of malignant epithelial tumors orbit and ocular adnexa. We present details technique toxicity data after orbit-sparing surgery followed by adjuvant proton therapy. Methods Materials Twenty patients underwent therapy for newly diagnosed lacrimal gland (n=7), sac/nasolacrimal duct (n=10), or eyelid (n=3). Tumor characteristics, details, visual outcomes were obtained from medical records. Acute chronic prospectively scored using Common Terminology Criteria Adverse Events version 4.0. Results The median dose was 60 Gy(RBE) (relative biological effectiveness; [range 50-70 Gy]); 11 received concurrent chemotherapy. Dose to ipsilateral anterior optic structures reduced 13 having them gaze away target during treatment. At a follow-up time 27.1 months (range 2.6-77.2 months), no patient had experienced local recurrence; 1 regional distant recurrence. Three developed grade 3 epiphora, exposure keratopathy. Four decrease acuity baseline but maintained vision sufficient perform all activities daily living without difficulty. Patients with ≥3 higher maximum cornea (median 46.3 Gy[RBE], range 36.6-52.7 Gy[RBE] vs 37.4 Gy[RBE], 9.0-47.3 Gy(RBE); P =.017). Conclusions Orbit-sparing adnexa successfully achieved disease control well tolerated. No required orbital exenteration enucleation. Chronic associated high cornea. An eye-deviation can be used limit corneal