Irradiation with electrons is the primary treatment regime for localized conjunctival low-grade lymphomas. However, radiation-induced cataracts are a major cause of treatment-related morbidity. This study investigates whether lens-sparing electron irradiation produces sufficient disease control rates while preventing cataract formation. All consecutive patients with strictly conjunctival, low-grade Ann Arbor stage IE lymphoma treated with superficial electron irradiation between 1999 and 2021 at our department were reviewed. A total of 56 patients with 65 treated eyes were enrolled with a median follow-up of 65 months. The median dose was 30.96 Gy. A lens-spearing technique featuring a hanging rod blocking the central beam axis was used in 89.2% of all cases. Cumulative incidences of 5- and 10-year infield recurrences were 4.3% and 14.6%, incidences of 5- and 10-year outfield progression were 10.4% and 13.4%. We used patients with involvement of retroorbital structures treated with whole-orbit photon irradiation without lens protection—of which we reported in a previous study—as a control group. The cumulative cataract incidence for patients treated with electrons and lens protection was significantly lower (p= 0.005) when compared to patients irradiated without lens protection. Thus, electrons are an effective treatment option for conjunctival low-grade lymphomas. The presented lens-sparing technique effectively prevents cataract formation.
电子束照射是治疗局限性结膜低级别淋巴瘤的主要方法，但放射性白内障是治疗相关并发症的主要原因。本研究旨在探讨晶状体保留电子束照射是否能在预防白内障形成的同时提供足够的疾病控制率。我们回顾了1999年至2021年间在我科接受浅表电子束照射治疗的、严格局限于结膜的低级别Ann Arbor分期IE期淋巴瘤的所有连续患者。共纳入56例患者（65只治疗眼），中位随访时间为65个月。中位照射剂量为30.96 Gy。89.2%的病例采用了以悬挂杆阻挡中心束轴为特点的晶状体保留技术。5年和10年野内复发的累积发生率分别为4.3%和14.6%，5年和10年野外进展的发生率分别为10.4%和13.4%。我们以既往研究中报道的、累及眶后结构并接受全眼眶光子照射（无晶状体保护）的患者作为对照组。与未进行晶状体保护照射的患者相比，接受电子束照射并采用晶状体保护技术的患者白内障累积发生率显著降低（p=0.005）。因此，电子束是治疗结膜低级别淋巴瘤的有效选择。所采用的晶状体保留技术能有效预防白内障形成。
肿瘤(癌症)患者之家