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Exploring Radiation Therapy for Orbital Involvement in Patients with Mantle Cell Lymphoma
Mantle cell lymphoma (MCL) with optic nerve involvement is a rare oncologic process, with whole-brain radiation therapy conventionally utilized as a palliative treatment (Radiol Imaging Cancer. 2022; 4(4):e220027. doi:10.1148/rycan.220027.)
Dr Ricky Savjani, MD, PhD, (Departments of Radiation Oncology, Integrative Biology and Physiology, Hematology and Oncology, and Neuro-Ophthalmology, University of California, Los Angeles, CA) and colleagues illustrated an intensity-modulated radiation therapy plan that spares the full risk of neurotoxicity.
The researchers noted that this was especially critical given previous and ongoing systemic and intrathecal chemotherapy and especially for patients who are elderly and/or have pre-existing neurocognitive conditions.
The publication provided imagery of orbital contrast enhanced MRI in a patient with MCL with bilateral optic nerve involvement who received orbital radiation therapy. Images of the fundoscopic examination in the same patient before and after radiotherapy were also provided. Following radiation, the patient’s visual acuity enhanced significantly in the left eye from hand motions to 20/100, as the examination revealed resolving optic disc edema and diminished vasculature dilation.
The authors note that the images in the study demonstrate the clinical benefits of orbital radiation as an effective, focal therapy for MCL involvement of the optic nerves, especially in patients who warrant urgent clinical intervention for progressive vision loss but who are unable to safely tolerate systemic therapy.
