Eye-sparing multidisciplinary approach for the management of lacrimal gland carcinoma

Head Neck. 2016 Aug;38(8):1258-62. doi: 10.1002/hed.24433. Epub 2016 Mar 29.

Abstract

Background: We analyzed local control and early ocular toxicity after eye-sparing management of lacrimal gland carcinoma.

Methods: For consecutive patients with lacrimal gland carcinoma treated during 2007 to 2014, we reviewed tumor characteristics, treatment details, ocular toxic effects, and recurrence.

Results: Twenty patients, median age 55 years, were treated for lacrimal gland carcinoma during the study period; 11 had globe-sparing surgery. Seven patients had adenoid cystic carcinoma, 2 had carcinoma ex pleomorphic adenoma, and 1 each had high-grade and low-grade adenocarcinoma. Ten patients underwent postoperative radiotherapy, median 60 Gy (range, 52-64 Gy), 6 with concurrent chemotherapy. At a median of 30 months after radiation, all patients had dry eye syndrome, and 1 patient had severe corneal and conjunctival damage leading to enucleation. All 11 patients were disease free at last contact, median follow-up after surgery of 33 months.

Conclusion: An eye-sparing approach with surgery followed by adjuvant radiotherapy or chemoradiotherapy is feasible for selected patients with lacrimal gland carcinoma and is associated with a reasonable locoregional control and ocular toxicity profile. © 2016 Wiley Periodicals, Inc. Head Neck 38:1258-1262, 2016.

Keywords: adenocarcinoma; adjuvant; chemotherapy; intensity-modulated; lacrimal apparatus; proton therapy; radiotherapy.

Publication types

  • Comparative Study

MeSH terms

  • Academic Medical Centers
  • Adenocarcinoma / mortality
  • Adenocarcinoma / pathology
  • Adenocarcinoma / surgery*
  • Adenocarcinoma / therapy
  • Adenoma, Pleomorphic / mortality
  • Adenoma, Pleomorphic / pathology
  • Adenoma, Pleomorphic / surgery
  • Adult
  • Aged
  • Cancer Care Facilities
  • Chemoradiotherapy / methods
  • Cohort Studies
  • Combined Modality Therapy
  • Eye Neoplasms / mortality
  • Eye Neoplasms / pathology
  • Eye Neoplasms / surgery*
  • Eye Neoplasms / therapy
  • Female
  • Humans
  • Lacrimal Apparatus / pathology
  • Lacrimal Apparatus / surgery*
  • Male
  • Middle Aged
  • Ophthalmologic Surgical Procedures / methods*
  • Organ Sparing Treatments / methods*
  • Prognosis
  • Retrospective Studies
  • Risk Assessment
  • Survival Rate
  • Texas
  • Treatment Outcome