Publication Only: Aggressive non-Hodgkin lymphoma - Clinical
Non-Hodgkin Lymphomas (NHL) effected organ of vision compose 8-12 % of all primary extranodal NHL, and may be the first and only sign of the disease.
To estimate a therapy of patients with extranodal orbital lesion in our cancer center.
Since 2014 to 2018 in our center treated 17 patients with extranodal damage to the orbit of the eyes. The age of patients ranged from 23 to 92 years, the average age of patients was 57 years. The number of men were 8 people, women - 9. Unilateral orbital damage was registered in 15 patients, bilaterally in 2 patients. In 12 cases process localized in the anterior part of the orbit, in 5 - in the middle and deep parts of the orbit with the spread in the maxillary sinus. Clinical sings of NHL characterized with exophthalmos in varying degrees of severity, difficult reposition, displacement of the eyeball and restriction of its mobility, swelling of the eyelid. By all the observations: to 12 patients performed biopsy of the tumor, 4 patients underwent therapeutic and diagnostic orbitotomy by Killian, to 1 patient - eye orbit exentation. Histological variants: MALT- lymphomas - 4 patients, Diffuse B-cell Lymphoma - 8, Mantle Cell Lymphoma - 2 and Follicular Lymphoma - 2 patients.
All patients underwent 6 courses of chemotherapy according to the R-EPOCH protocol. Complete answer registered in 16 cases, partial answer in 1 of cases, and this patient received a course of radiation therapy on the affected area. Observation median was 3 years (15 month-5 years).
Therefore, treating orbital NHL requires complex multidisciplinary approach, allowing determining the correct diagnosis and prescribing adequate treatment. Standart first line therapy achieved good results of relapse-free survival. Chemotherapy showed the same results as the combined treatment (chemotherapy and orbitotomy).