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Radiotherapy for nasolacrimal tract epithelial cancer
R H Sagerman1, A K Fariss, C T Chung
1Department of Radiology, SUNY Health Science Center, Syracuse 13210.
Summary
Radiation therapy effectively controls lacrimal sac tumors, offering good cosmetic outcomes. Elective cervical nodal irradiation is recommended for poorly differentiated cancers.
Area of Science:
- Ophthalmology
- Radiation Oncology
Background:
- Lacrimal sac tumors are rare, with surgery as the traditional treatment.
- Investigating irradiation as a primary treatment modality for these rare tumors.
Observation:
- Three patients with primary epithelial nasolacrimal apparatus cancer received irradiation.
- Tumor doses ranged from 52-66 Gy with conventional fractionation.
- Treatment fields were localized to the primary tumor and surrounding tissues.
Findings:
- Complete local tumor control was achieved in all three patients.
- Two patients developed metastatic cervical adenopathy, successfully managed with neck irradiation.
- One patient died from distant metastases; two remain disease-free at 13 years and 26 months.
Implications:
- Radiation therapy is a viable and effective treatment for epithelial lacrimal sac tumors.
- Achieving good cosmetic results alongside tumor control is possible with irradiation.
- The findings support the need for elective cervical nodal irradiation in poorly differentiated cases.