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Radiation therapy for primary carcinoma of the eyelid: tumor control and visual function

Strahlenbehandlung bei primärem Karzinom des Augenlids: Tumorkontrolle und Sehfunktion

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Abstract

Background and purpose

Surgical excision remains the standard and most reliable curative treatment for eyelid carcinoma, but frequently causes functional and cosmetic impairment of the eyelid. We therefore investigated the efficacy and safety of radiation therapy in eyelid carcinoma.

Patients and methods

Twenty-three patients with primary carcinoma of the eyelid underwent radiation therapy. Sebaceous carcinoma was histologically confirmed in 16 patients, squamous cell carcinoma in 6, and basal cell carcinoma in 1. A total dose of 50–66.6 Gy (median, 60 Gy) was delivered to tumor sites in 18–37 fractions (median, 30 fractions).

Results

All but 3 of the 23 patients had survived at a median follow-up period of 49 months. The overall survival and local progression-free rates were 87% and 93% at 2 years, and 80% and 93% at 5 years, respectively. Although radiation-induced cataracts developed in 3 patients, visual acuity in the other patients was relatively well preserved. There were no other therapy-related toxicities of grade 3 or greater.

Conclusion

Radiation therapy is safe and effective for patients with primary carcinoma of the eyelid. It appears to contribute to prolonged survival as a result of good tumor control, and it also facilitates functional and cosmetic preservation of the eyelid.

Zusammenfassung

Hintergrund und Ziel

Die chirurgische Entfernung bleibt immer noch die Standard- und verlässlichste Behandlungsform für Karzinomata des Augenlids, führt jedoch häufig auch zu funktionellen und kosmetischen Beeinträchtigungen des Augenlids. Daher haben wir die Effizienz und Sicherheit der Strahlenbehandlung für Augenlidkarzinome untersucht.

Patienten und Methoden

Insgesamt 23 Patienten mit primärem Karzinom des Augenlids erhielten eine Strahlentherapie. Bei 16 dieser Patienten wurden Talgdrüsenkarzinome histologisch nachgewiesen, bei 6 Patienten Plattenepithelkarzinome und bei ein Patienten ein Basaliom. Die Tumoren wurden mit einer auf 18–37 Fraktionen (durchschnittlich 30 Fraktionen) verteilten Gesamtdosis von 50–66,6 Gy (durchschnittlich 60 Gy) bestrahlt.

Ergebnisse

Bis auf 3 Fälle zeigten die Nachuntersuchungen, dass alle der 23 Patienten durchschnittlich 49 Monate überlebten. Die Gesamtüberlebensrate und die Rate für das lokal progressionsfreie Überleben waren jeweils nach 2 Jahren 87 bzw. 93% und nach 5 Jahren 80 bzw. 93%. Obwohl sich bei 3 Patienten strahlungsinduzierte Katarakte bildeten, war die Sehschärfe bei den anderen Patienten verhältnismäßig gut erhalten. Andere, behandlungsbezogene toxische Reaktionen mit einem Schweregrad von 3 oder mehr traten nicht auf.

Schlussfolgerung

Die Strahlentherapie ist sicher und effektiv für Patienten mit primärem Karzinom des Augenlids. Sie scheint außerdem durch gute Tumorkontrolle zu einem längeren Überleben beizutragen und begünstigt die funktionelle und kosmetische Erhaltung des Augenlids.

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Conflict of interest

On behalf of all authors, the corresponding author states that there are no conflicts of interest.

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Authors and Affiliations

  1. Department of Radiology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, 236-0004, Yokohama, Kanagawa, Japan

    M. Hata MD, I. Koike, K. Odagiri, T. Kasuya, Y. Minagawa, H. Kaizu, Y. Mukai & T. Inoue

  2. Department of Plastic and Reconstructive Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan

    J. Maegawa

  3. Department of Ophthalmology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan

    A. Kaneko

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  1. M. Hata MD
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  2. I. Koike
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  3. J. Maegawa
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  4. A. Kaneko
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  5. K. Odagiri
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  6. T. Kasuya
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  7. Y. Minagawa
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  8. H. Kaizu
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  9. Y. Mukai
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  10. T. Inoue
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Corresponding author

Correspondence to M. Hata MD.

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Hata, M., Koike, I., Maegawa, J. et al. Radiation therapy for primary carcinoma of the eyelid: tumor control and visual function. Strahlenther Onkol 188, 1102–1107 (2012). https://doi.org/10.1007/s00066-012-0145-9

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  • DOI: https://doi.org/10.1007/s00066-012-0145-9

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