Clinical Research Papers:
Chemotherapy alone is an alternative treatment in treating localized primary ocular adnexal lymphomas
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Wei-Li Ma1,2,5,6,7, Ming Yao3, Shu-Lang Liao4, Jih-Luh Tang3, Yao-Ching Wang8, Sung-Hsin Kuo2,5,6,7 and Ann-Lii Cheng2,3,5,6,7
1Department of Oncology, National Taiwan University Hospital, Yun-Lin Branch, Yun-Lin, Taiwan
2Department of Oncology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
3Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
4Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
5National Taiwan University Cancer Center, National Taiwan University College of Medicine, Taipei, Taiwan
6Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan
7Cancer Research Center, National Taiwan University College of Medicine, Taipei, Taiwan
8Department of Biomedical Imaging and Radiological Science, College of Health Care, China Medical University, Taichung, Taiwan
Sung-Hsin Kuo, email: [email protected]
Keywords: ocular adnexal lymphomas, chemotherapy, radiotherapy, event-free survival, overall survival
Received: July 29, 2016 Accepted: May 29, 2017 Published: June 15, 2017
This study investigated the treatment efficacy and long-term adverse effects of various treatment modalities for primary ocular adnexal lymphomas (POALs). We retrospectively reviewed 107 patients who received first-line chemotherapy, radiotherapy, and other treatment modalities from 1990 to 2015. Nighty-three (87%) patients were diagnosed with mucosa-associated lymphoid tissue (MALT) lymphoma, with the orbit being the most common site (49 patients, 46%). Among 91 patients with stage I–IIE1 disease, 26 underwent chemotherapy, 34 underwent radiotherapy, and 31 received other treatment modalities. For chemotherapy, radiotherapy, and other treatment modalities, the 5-year event-free survival (EFS) rates were 90.0%, 89.7%, and 85.8% and the 5-year overall survival (OS) rates were 100%, 90.4%, and 87.5%, respectively. Moreover, among 80 patients with stage I–IIE1 MALT lymphoma, the complete remission, 5-year EFS and OS rates were not significantly different between patients receiving chemotherapy and those receiving radiotherapy. Among 16 patients with stage IIE2–IVE disease, the 5-year EFS rates for chemotherapy alone (n = 11) and combined radiotherapy and chemotherapy (n = 5) were 61.7% and 80%, respectively, whereas the 5-year OS rate for both groups was 80.0%. Neutropenia (15.2%) was the most common side effect in patients who received chemotherapy, whereas cataract (16.3%) was the most common late sequela in patients who received radiotherapy. Multivariate analysis revealed that old age (> 60 y) and an advanced stage (stage III/IV) were prognostic factors for poor OS. Our results indicate that chemotherapy yields satisfactory disease control and fewer side effects, and acts as an alternative therapy for patients with localized POALs.
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