Radiation Therapy for Orbital and Adnexal Tumors

Chapter
Part of the M.D. Anderson Solid Tumor Oncology Series book series (MDA, volume 6)

Abstract

Radiation therapy is used in the multimodality treatment of many orbital and adnexal tumors to enhance local control and possibly, in some patients, overall survival. In this chapter we will review the indications, modern techniques, potential toxic effects, and expectations of tumor control for a variety of orbital and adnexal tumors. Typically, treatments are delivered in fractions of 1.8–2.0 Gy per day, with the total number of fractions depending on the inherent radiosensitivity of the lesion. Radiotherapy technique and field design depends on the required dose, the tumor type, and the surrounding normal structures such as the lens, which is at risk of a cataract after a dose as low as 2 Gy. Excellent functional outcomes are evident for patients with optic nerve meningiomas with 5-year local control rates greater than 90% after local radiation therapy alone. In patients with orbital rhabdomyosarcoma, chemotherapy with radiation therapy results in excellent 5-year survival rates. Recently, we have been evaluating the role of oculoplastic procedures followed by adjuvant radiation therapy in lieu of orbital exenteration for patients with locally advanced ocular adnexal cancers.

Keywords

Entropion Lymphoma Cobalt Adenocarcinoma Tungsten 

References

  1. 1.
    Miralbell R, Cella L, Weber D, et al. Optimizing radiotherapy of orbital and paraorbital tumors: intensity-modulated X-ray beams vs. intensity-modulated proton beams. Int J Radiat Oncol Biol Phys 2000;47(4):1111–9.PubMedCrossRefGoogle Scholar
  2. 2.
    Petsuksiri J, Frank SJ, Garden AS, et al. Outcomes after radiotherapy for squamous cell carcinoma of the eyelid. Cancer 2008;112(1):111–8.PubMedCrossRefGoogle Scholar
  3. 3.
    Hsu A, Frank S, Ballo MT, et al. Postoperative adjuvant external-beam radiation therapy for cancers of the eyelid and conjunctiva. Ophthal Plast Reconstr Surg 2008;24(6):444–9.PubMedCrossRefGoogle Scholar
  4. 4.
    Melian E, Jay WM. Primary radiotherapy for optic nerve sheath meningioma. Semin Ophthalmol 2004;19(3–4):130–40.PubMedCrossRefGoogle Scholar
  5. 5.
    Eddleman CS, Liu JK. Optic nerve sheath meningioma: current diagnosis and treatment. Neurosurg Focus 2007;23(5):E4.PubMedCrossRefGoogle Scholar
  6. 6.
    Timmermann B, Schuck A, Niggli F, et al. “Spot-scanning” proton therapy for rhabdomyosarcomas of early childhood. First experiences at PSI. Strahlenther Onkol 2006;182(11):653–9.PubMedCrossRefGoogle Scholar
  7. 7.
    Yock T, Schneider R, Friedmann A, et al. Proton radiotherapy for orbital rhabdomyosarcoma: clinical outcome and a dosimetric comparison with photons. Int J Radiat Oncol Biol Phys 2005;63(4):1161–8.PubMedCrossRefGoogle Scholar
  8. 8.
    Parsons JT, Bova FJ, Fitzgerald CR, et al. Severe dry-eye syndrome following external beam irradiation. Int J Radiat Oncol Biol Phys 1994;30:775–80.PubMedCrossRefGoogle Scholar
  9. 9.
    Brady LW, Shields J, Augusburger J, et al. Complications from radiation therapy to the eye. Front Radiat Ther Oncol 1989;23:238–50.PubMedGoogle Scholar
  10. 10.
    Hungerford J. Current management of choroidal malignant melanoma. Br J Hosp Med 1985;34:287–93.PubMedGoogle Scholar
  11. 11.
    Jiang GL, Tucker SL, Guttenberger R, et al. Radiation-induced injury to the visual pathway. Radiother Oncol 1994;30:17–25.PubMedCrossRefGoogle Scholar
  12. 12.
    Parsons JT, Bova FJ, Fitzgerald CR, et al. Radiation retinopathy after external-beam irradiation: analysis of time–dose factors. Int J Radiat Oncol Biol Phys 1994;30(4):765–73.PubMedCrossRefGoogle Scholar
  13. 13.
    Parsons JT, Bova FJ, Fitzgerald CR, et al. Radiation optic neuropathy after megavoltage external-beam irradiation: analysis of time–dose factors. Int J Radiat Oncol Biol Phys 1994;30(4):755–63.PubMedCrossRefGoogle Scholar
  14. 14.
    Diba R, Saadati H, Esmaeli B. Outcomes of dacryocystorhinostomy in patients with head and neck tumors. Head Neck 2005;27:72–75.PubMedCrossRefGoogle Scholar
  15. 15.
    Miralbell R, Lomax A, Cella L, et al. Potential reduction of the incidence of radiation-induced second cancers by using proton beams in the treatment of pediatric tumors. Int J Radiat Oncol Biol Phys 2002;54(3):824–9.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Department of Radiation OncologyThe University of Texas M.D. Anderson Cancer CenterHoustonUSA

Personalised recommendations