Tomotherapy Treatment of Chronic Lymphocytic Leukemia and Ocular Lymphoma
Journal Title: Journal of Case Reports and Studies - Year 2018, Vol 6, Issue 3
Abstract
Objective: To describe two cases of radiation therapy for ocular and near ocular targets with helical tomotherapy. Methods: A sixty-five-years-old male patient with history of non-Hodgkin’s lymphoma of the right orbit and a fifty-years-old female patient with chronic lymphocytic leukemia with peripheral lymphocytosis were treated on TomoTherapy. In the first case, a 1 cm beam was used for planning a delivery of 30.6 Gy in 17 fractions with a sequential boost of 9 Gy in 5 fractions. Tumor involvement of the ipsilateral lens and lacrimal gland in the planning target volume necessitated a compromise between preserving patient’s vision and delivery of tumoricidal dose to the target. In the second case, 30 Gy in 20 fractions delivery was planned with a 2.5 cm beam. The tumor extended anteriorly and this technique allowed sparing more orbital tissue and required a high modulation factor. Results: The plan for non-Hodgkin’s lymphoma resulted in sufficient target coverage with the mean doses to the ipsilateral eye lens and lacrimal gland of 23.44 and 24.87 Gy, respectively. Treatment was generally well-tolerated and acute toxicity profile was mild. For the patient with chronic lymphocytic leukemia low doses of 5.94 Gy for the left lens and 6.00 Gy for the right lens were achieved, while assuring the mean dose to the target of required 30.5 Gy. Long term follow up has demonstrated excellent cosmetic results and clinical outcome. Conclusion: Helical tomotherapy has proved to be effective treatment technique for ocular and near ocular targets.
Authors and Affiliations
Yartsev S
Keywords
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- EP ID EP584750
- DOI 10.15744/2348-9820.6.301
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