Medical Radiology and Radiation Safety. 2012. Vol. 57. No. 5. P. 37-41

RADIATION THERAPY

N.V. Ilyin, Yu.N. Vinogradova, A.I. Karyagina, A.I. Urbansky, E.V. Trishkina

Electron-Photon Therapy in Malignant Solid Tumors Treatment with Lesions of the Eye

Russian Research Centre for Radiology and Surgical Technologies, Saint-Petersburg, Russia. E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Abstract

Purpose: To increase the radiation therapy efficacy in ophthalmooncological patients.

Material and methods: Investigation includes 36 patients with verified malignant solid tumors with lesions of the organ of sight - 32 patients with recurrence after operative treatment and 4 patients with metastases in the orbit. In 16 patients, besides the lesion of eyelids and orbit, an involvement of the maxillary sinus, ethmoidal labyrinth, frontal sinus, skin and soft tissues of face was revealed. All patients received electron-photon therapy (EFT) within period of 1994-2011, including irradiation of the structures of the organ of sight, and in 16 patients, in addition, neighboring injured areas. EFT was carried out at electron linear accelerators SL 75-5 (Philips) of 6 MeV and Elekta Precise by bremsstrahlung radiation of 6 and 18 MV or electrons of 4-18 MeV in 3 regimen of fractionation – conventional (CF, 18 patients), average (AF, 9 patients) and multi-fractionation (MF, 9 patients) to total focal equivalent doses of 55-70 Gy.

Results: After EFT, an objective response was recorded in 29 patients out of 36 (80.6 %), in 12 (33.3 %) out of them - complete response; stabilization was observed in 11 (19.5 %) patients without any

progression at the background of the treatment. In case of the irradiation of eyelids or eyelids and neighbouring structures, the complete or partial remission was noted in all patients; in EFT of the orbit or orbit and neighbouring structures, the response was recorded in 73.9 % of patients (p < 0.01). Irradiation of patients in regimen AF and MF was more effective in comparison with CF - 94.4 % and 66.7 % remissions, correspondingly, p < 0.01; and only in locally spread tumors, the response to the treatment was observed in all patients received EFT in regimen AF and MF. EFT enables to reveal early radiation reactions of stages I-II in 83.7 % of patients; there were not severe complications; reactions rate was higher in CF (94.4 % of patients) and in total in CF and AF (92.6 % of patients) than that in patients irradiated twice a day - 66.7 % of patients, p < 0.05. Onset time of radiation reactions appearance did not depend on fractionation regimen. After EFT, overall 3-5-year survival was 85.9 % and 70.4 %, respectively.

Conclusion: EFT is the important and effective method of treatment in patients with malignant solid tumors with lesions of the organ of sight.

Key words: radiotherapy, organ of sight, solid tumors