Orbital carcinomas treated with adjuvant intensity‐modulated radiation therapy

Tao, Randa; Ma, Dominic; Takiar, Vinita; Frank, Steven J.; Fuller, Clifton D.; Gunn, G. Brandon; Beadle, Beth M.; Morrison, William H.; Rosenthal, David I.; Edson, Mark A.; Esmaeli, Bita; Kupferman, Michael E.; Hanna, Ehab Y.; Garden, Adam S.; Phan, Jack

doi:10.1002/hed.24044

Cited by 10 publications

(6 citation statements)

References 21 publications

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“…Furthermore, patients with lacrimal gland tumors achieved 2-year LPFS and RRFS rates of 100 and 88.9%, respectively, although ~ 40% had T4 disease. Our results mimicked the most favorable 2-year outcome in terms of survival and local control despite of a less favorable clinical presentation [21, 24, 26, 27].…”

Section: Discussionsupporting

confidence: 73%

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

Gao

et al. 2019

BMC Cancer

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Background To report the clinical experience of eye sparing surgery (ESS) and adjuvant carbon-ion or proton radiotherapy (CIRT or PRT) for orbital malignancies. Methods An 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. Results Between 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. Conclusion With few observed acute and late toxicities, particle radiotherapy following ESS provided effective local control with infrequent severe toxicities for patients with orbital malignancies.

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Section: Discussionsupporting

confidence: 73%

“…Three- or 5-year LPFS rates of 60~65% [21, 23], with similar OS rates of 60% have been reported. In a more recently published series, adjuvant IMRT after exenteration produced a 3-year LPFS and OS rates of 91 and 70%, respectively [24].…”

Section: Discussionmentioning

confidence: 99%

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

Gao

et al. 2019

BMC Cancer

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“…Most postoperative radiotherapy is conformal radiotherapy. 5,6 This study reported the outcome and toxicity for ACCHN patients treated by surgery combined with intensity modulated conformal radiotherapy (IMRT) in a single institute.…”

Section: Introductionmentioning

confidence: 99%

Outcome of Adenoid Cystic Carcinoma of Head and Neck After Postoperative Intensity Modulation Radiotherapy: A Single Institution Study

Wang

Luo

et al. 2021

CMAR

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This study was retrospectively evaluated the outcome of postoperative intensity modulation radiotherapy (IMRT) for patients with adenoid cystic carcinoma of head and neck (ACCHN), and identified the unfavorable prognostic factors. Methods: Fifty-five ACCHN patients treated in Sichuan Cancer Hospital between January 2007 and December 2016 were retrospectively evaluated. Median age of patient was 47 years (range, 21-73 years). Thirty-five patients were male and 20 were female. In 30 patients, tumors were located in major salivary glands (54.5%), and 25 patients in minor salivary glands (45.5%). The numbers of R0, R1, and R2 surgical resection classification patients were 22 (40.0%), 20 (36.4%), and 13 (23.6%). The median total RT dose was 62 Gy (range, 46-72 Gy), and 54.5% of patients were treated with adjuvant chemotherapy. Statistical analyses were performed using the Log rank test for univariate analysis and the Cox proportional hazard model for multivariate analysis. Results: Median follow-up period was 68.5 months (12-132 months). The 5-year local-regional recurrence-free survival (LRRFS), distant metastasis-free survival (DMFS) and overall survival (OS) were 93.9%, 75.3% and 82.5%. In univariate analysis, T stages (p=0.025) and AJCC stages (p=0.036) were the prognostic factors for OS; Age (p=0.042), T stages (p=0.025), N stages (p=0.021), AJCC stages (p=0.021) and adjuvant chemotherapy (p=0.010) were the prognostic factors for DMFS; T stage (p=0.049) was the prognostic factor for LRRFS. In multivariate factors analyses, T stages (p=0.026), AJCC stages (p=0.028) and RT dose (p=0.025) were the significant prognosticators for OS. The most common acute toxicities over three degrees were myelosuppression (5.5%), mucositis (9.1%) and dermatitis (1.8%). Conclusion: Postoperative IMRT seems to achieve reasonable local-regional control and OS in patients with adenoid cystic carcinoma of head and neck, with acceptable treatment relative toxicities.

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“…Aggressive orbital malignant tumors are also treated with orbital exenteration because of the complexity of the surrounding anatomy. 3 , 9 , 10 In recent years, a multidisciplinary orbit‐sparing treatment approach is generally recommended when feasible to preserve some extent of visual function while maintaining high rates of local control. 9 In a study of 29 locally advanced orbital malignant tumors, favorable oncological outcomes with a 5‐year survival rate of 60% and 5‐year local control rate of 83% were achieved by applying postoperative IMRT following orbital debridement.…”

Section: Discussionmentioning

confidence: 99%

“…The goal of achieving local control must be weighed against the toxicities and long‐term effects of treatments, which can result in significant morbidity, such as ipsilateral loss of vision and/or poor cosmetic impact. 3 Several recent studies have reported favorable oncological outcomes in patients with orbital malignant tumors treated with skull base surgery followed by adjuvant intensity‐modulated radiotherapy (IMRT) 3 , 4 , 5 or particle radiotherapy. 6 However, the roles of skull base surgery and particle radiotherapy have not been fully investigated due to its rarity and variety of histological types.…”

Section: Introductionmentioning

confidence: 99%

Roles of skull base surgery and particle radiotherapy for orbital malignant tumors involving the skull base

Teshima

Shinomiya

Kimura

et al. 2021

Laryngoscope Investig Oto

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Purpose: To investigate the oncological outcomes of orbital malignant tumors invading the skull base.Methods: A retrospective analysis was conducted on 16 patients with orbital malignant tumors invading the skull base. Eleven patients were treated with skull base surgery, four patients were treated with particle therapies, and one patient was treated with chemoradiotherapy (CRT) as initial treatment.Results: The most frequent histological type was adenoid cystic carcinoma in seven patients, followed by squamous cell carcinoma in two patients. Local recurrence occurred in two of the six surgically treated patients who did not receive postoperative radiotherapy (RT) or CRT. One of them was successfully salvaged by RT, and the other died of disease. With a median follow-up of 24 months, the 2-year overall, local control, and disease-free survival rates of all patients were 82.5%, 87.5%, and 59%, respectively.Conclusions: Patients with positive surgical margins were at risk of local recurrence.Postoperative RT should be considered for all surgically treated patients.

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Orbital carcinomas treated with adjuvant intensity‐modulated radiation therapy

Abstract: Favorable disease control rates for orbital carcinomas are achievable with IMRT after orbital exenteration even for patients with advanced disease. Toxicity for the contralateral eye was minimal. © 2015 Wiley Periodicals, Inc. Head Neck 38: E580-E587, 2016.

Cited by 10 publications

References 21 publications

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

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

Outcome of Adenoid Cystic Carcinoma of Head and Neck After Postoperative Intensity Modulation Radiotherapy: A Single Institution Study

Roles of skull base surgery and particle radiotherapy for orbital malignant tumors involving the skull base

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