Abstract
Purpose :
Assessment and comparison of different treatment modalities, length of remission and clinical outcomes in orbital lymphoma patients
Methods :
A retrospective chart review was done on adult patients diagnosed with orbital lymphoma treated at Columbia University Medical Center. Specimens were obtained for pathology, immunohistochemistry, and flow cytometry to determine the lymphoma subtype. The orbital lymphoma primary location site, the presence or absence of systemic disease, treatment course, time frame to recurrence, and survival to date was determined. The data was used to assess the efficacy of treatment modalities, patient survival curve, and clinical outcomes in orbital lymphoma patients. Treatment modalities included oral doxycycline, oral rituximab, Boom-Boom radiation (2 sessions of 2-Gy/treatment session), and external beam radiation therapy XRT (27 Gy over a 4-week period).
Results :
83% (25/30 total n=30) of the patients in our cohort were found to have extranodal follicular B cell orbital lymphoma (EMBL) with an average age of 68.5 at presentation and an average follow- up length of 4.2 years. 28% (7/25) of EMBL patients were treated with Boom-Boom of which 2/7 had a local recurrence within 1 year of treatment. 16% (4/25) patients were treated with oral doxycycline of which 2/4 patients had a local recurrence within 1 year. 20% (5/25) were treated with systemic rituximab of which 3/5 patients developed a recurrence with 1 year. 30% (8/25) patients were treated with XRT for local EMBL and none of the patients had any local recurrence.
Conclusions :
Patients treated with XRT in the cohort had a complete resolution of local orbital lymphoma and had no evidence of recurrence at the 4- year follow up mark. Boom-Boom can be used as a reasonable first line treatment as the recurrence rate in our cohort was only 28% and patients receive a total of 4-Gy radiation delivered to the orbit. The recurrence rate of oral rituximab and doxycycline were similar, 60% vs 50% respectively.
This is a 2020 ARVO Annual Meeting abstract.