Palliative Radiotherapy of Retrobulbar Orbit Metastases due to Breast Cancer

Abstract

Background: In breast cancer, the occurrence of retrobulbar metastases of the orbit is rare compared to intraocular metastases. The clinical symptoms are quite different. Impairment of vision, exophthalmus, double vision, vertigo, and pain reduce patients’ quality of life. Patients and Methods: The benefit of palliative irradiation of the orbit was researched retrospectively in 7 patients. This report also presents the first case in the literature of a breast cancer patient with bi-orbital enophthalmus caused by bilateral retrobulbar metastases that were successfully treated with radiotherapy. Irradiation was performed by photon or electron beams (20–50 Gy). Clinical restaging was done at the end of radiotherapy and 6 weeks thereafter. Results: After irradiation, 6 out of 7 patients showed a distinct clinical response with good palliation and no major side effects. Exophthalmus, pain, and vertigo were significantly reduced in all cases. Double vision disappeared in 3 out of 4 patients, eye muscle paralysis in 5 out of 6 patients. The median overall survival after irradiation of the orbit was 7.3 months. Conclusion: Palliative radiotherapy of retrobulbar metastases of breast cancer is very effective in reducing acute clinical symptoms and increasing quality of life. Nonetheless, patients have a poor prognosis.

Low Expression of DDX60 Gene Might Associate with the Radiosensitivity for Patients with Breast Cancer

“…Palliative treatment can reduce the nidus, relieve pain, and extend life so as to improve the life quality of patients. For example, previous research showed that palliative radiotherapy of retrobulbar metastases of breast cancer could reduce acute clinical symptoms [24]. In addition, palliative radiotherapy also played an important role in treating breast cancer with brain metastases and leptomeningeal carcinomatosis [25].…”

Metástasis orbitarias del cáncer de mama

“…En la mayor parte de las series publicadas se ha objetivado que la radioterapia produce regresión de la afectación tumoral orbitaria y/o de sus síntomas en el cáncer de mama. En una serie australiana se encontró este resultado en tres de las cinco pacientes que fueron irradiadas paliativamente 65 . Las metástasis orbitarias de cáncer de mama en localización retrobulbar tienen una buena respuesta sintomática a la radioterapia, con mejoría de los síntomas de dolor, exoftamos, enoftalmos, vértigo, diplopia y oftalmoplegia 66 .…”