原发眼眶淋巴瘤28例放疗效果分析

Effect of radiotherapy for primary orbital lymphoma： analyses of 28 cases

目的分析原发眼眶淋巴瘤患者的放疗效果及不良反应。方法回顾性分析2006年3月至2012年8月就诊于天津市人民医院、天津市第一中心医院、天津市大港油田医院的28例原发眼眶淋巴瘤患者的临床资料。所有患者均行眶内肿物活组织检查或切除术，术后接受放疗，3例于放疗前行CHOP方案化疗。放疗采用三维适形调强技术，3～5野，2～2．5Gy／次，每周5次，总剂量20～50Gy。其中30Gv18例，22Gy1例，25Gy1例，20Gy1例，28．8Gy1例，40Gy3例，42Gy1例，46Gy1例和50Gy1例。结果28例患者放疗后均获完全缓解，其中1例放疗4个月后局部复发，再次放疗后完全缓解；1例死于淋巴瘤肺浸润。放疗期间发生急性并发症有结膜炎（28例，100．0％）和角膜炎（1例，3．6％），远期并发症有眼干燥症（10例，35．7％）和视力下降（1例，3．6％）。结论放疗是原发眼眶淋巴瘤有效的治疗方法，多数患者对不良反应耐受良好。

Objective To analyze the effect and adverse reactions of radiotherapy in patients with primary orbital lymphoma. Methods A total of 28 patients with primary orbital lymphoma from Tianjin Union Medical Center, the First Central Hospital of Tianjin and Tianjin Dagang Oil Company Hospital between March 2006 and August 2012 were retrospectively analyzed. All the patients received orbital tumor dissection or biopsy, then received radiation therapy. Three patients received chemotherapy with CHOP protocol before radiotherapy. Radiotherapy was delivered routinely with 3D-conformal radiation therapy （CRT） technique with daily 2 - 2.5 Gy for 5 times per week and 3-5 fields. Total dosage was 20-50 Gy. There were 18 cases of 30 Gy, 1 case of 22 Gy, 1 case of 25 Gy, 1 case of 20 Gy, 1 case of 28.8 Gy, 3 cases of 40 Gy, 1 case of 42 Gy, 1 case of 46 Gy and 1 case of 50 Gy. Results All the patients had complete remission （CR） after radiotherapy during follow-up. One patient recurred after radiotherapy of 4 months and received CR with radiotherapy again. One patient died of lung infiltration. Acute complications during radiotherapy were conjunctivitis （28 cases, 100.0 %） and keratitis （1 case, 3.6 %）, long-term complications with ophthalmoxerosis （10 cases, 35.7 %） and decreased visual acuity （1 case, 3.6 %）. Conclusion Radiotherapy is an effective method for primary orbital lymphoma, and the adverse reactions can be tolerated for most patients.