Chemotherapy alone is an alternative treatment in treating localized primary ocular adnexal lymphomas

Abstract

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.

Chemotherapy Compared with Radiotherapy as the First-line Therapy of Extranodal Marginal Zone Lymphoma: A Review

“…Two studies by Ma et al and Simon et al also used low dose of cyclophosphamide or chlorambucil as the primary treatment for the stage I disease include in their studies. 8,9 In adition, studies that used radiotherapy as the first-line therapy had similar dosage and regimen. The baseline characteristic between studies was summarized in Table 1.…”

Rituximab Monotherapy for Compressive Optic Neuropathy With Giant Ocular Adnexal Mucosa–Associated Lymphoid Tissue lymphoma

“…Although the findings of retrospective studies have shown us that both EBRT and rituximab monotherapy are effective for OAML regression, rituximab monotherapy is less prone to side effects with considerably low recurrence rate. 2…”

“…1 However, anti-CD20 monoclonal antibody (rituximab) monotherapy has recently reported that it is significantly effective for the treatment of OAML, and that it minimizes the burden on the patient. 2 Regarding efficacy of rituximab for follicular lymphoma, a Phase 3 clinical randomized control trial concluded that rituximab monotherapy, radiation therapy, and "watch and wait" are selected in the limited initial stages (i.e., stages I and II), while on the other hand, rituximab monotherapy, cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), and rituximab-CHOP (R-CHOP) are selected in the advanced stages (i.e., stages III and IV). 3 Herein, report a first case of developing compressive optic neuropathy due to massive primary OAML of the orbit, which was improved dramatically to save the sight by rituximab monotherapy alone.…”

Current Status of the Spectrum and Therapeutics of Helicobacter pylori-Negative Mucosa-Associated Lymphoid Tissue Lymphoma

“…For localized and antibiotic-refractory HP-negative gastric MALT lymphoma, radiotherapy (RT) can provide local control but may induce acute and chronic adverse effects [ 10 , 20 , 95 , 96 ]. For example, patients with OAML who received RT had a high CR rate and promising event-free survival (EFS) but experienced side effects, such as cataracts, dry eyes, and keratitis [ 95 , 97 ]. However, several studies have demonstrated that reduction in RT (field or dose) not only provides promising therapeutic efficacies, but also has lower adverse effects for localized MALT lymphoma [ 96 , 98 , 99 , 100 , 101 ].…”