PURPOSE: To review institutional outcomes for patients treated with external-beam radiotherapy (EBRT) for orbital pseudotumor. METHODS AND MATERIALS: This is a single-institution retrospective review of 20 orbits in 16 patients diagnosed with orbital pseudotumor that received EBRT at the University of Oklahoma, Department of Radiation Oncology. Treated patients had a median follow-up of 16.5 months. RESULTS: Fifteen patients (93.7%) were initially treated with corticosteroids. Eight had recurrence after steroid cessation, six were unable to taper corticosteroids completely or partially, and one experienced progression of symptoms despite corticosteroid therapy. Fourteen patients (87.5%) initially responded to radiotherapy indicated by clinical improvement of preradiation symptoms and/or tapering of corticosteroid dose. Mean EBRT dose was 20 Gy (range, 14-30 Gy). Thirteen patients (81.2%) continued to improve after radiation therapy. Patient outcomes were complete cessation of corticosteroid therapy in nine patients (56.3%) and reduced corticosteroid dose in four patients (25%). Radiotherapy did not achieve long-term control for three patients (18.7%), who still required preradiation corticosteroid dosages. Three patients received retreatment(s) of four orbits, of which two patients achieved long-term symptom control without corticosteroid dependence. One patient received retreatment to an orbit three times, achieving long-term control without corticosteroid dependence. No significant late effects have been observed in retreated patients. CONCLUSIONS: Radiotherapy is an effective treatment for acute symptomatic improvement and long-term control of orbital pseudotumor. Orbital retreatment can be of clinical benefit, without apparent increase in morbidity, when initial irradiation fails to achieve complete response.
PURPOSE: To review institutional outcomes for patients treated with external-beam radiotherapy (EBRT) for orbital pseudotumor. METHODS AND MATERIALS: This is a single-institution retrospective review of 20 orbits in 16 patients diagnosed with orbital pseudotumor that received EBRT at the University of Oklahoma, Department of Radiation Oncology. Treated patients had a median follow-up of 16.5 months. RESULTS: Fifteen patients (93.7%) were initially treated with corticosteroids. Eight had recurrence after steroid cessation, six were unable to taper corticosteroids completely or partially, and one experienced progression of symptoms despite corticosteroid therapy. Fourteen patients (87.5%) initially responded to radiotherapy indicated by clinical improvement of preradiation symptoms and/or tapering of corticosteroid dose. Mean EBRT dose was 20 Gy (range, 14-30 Gy). Thirteen patients (81.2%) continued to improve after radiation therapy. Patient outcomes were complete cessation of corticosteroid therapy in nine patients (56.3%) and reduced corticosteroid dose in four patients (25%). Radiotherapy did not achieve long-term control for three patients (18.7%), who still required preradiation corticosteroid dosages. Three patients received retreatment(s) of four orbits, of which two patients achieved long-term symptom control without corticosteroid dependence. One patient received retreatment to an orbit three times, achieving long-term control without corticosteroid dependence. No significant late effects have been observed in retreated patients. CONCLUSIONS: Radiotherapy is an effective treatment for acute symptomatic improvement and long-term control of orbital pseudotumor. Orbital retreatment can be of clinical benefit, without apparent increase in morbidity, when initial irradiation fails to achieve complete response.
Authors: Nam P Nguyen; Shane P Krafft; Paul Vos; Vincent Vinh-Hung; Misty Ceizyk; Siyoung Jang; Anand Desai; Dave Abraham; Lars Ewell; Christopher Watchman; Russ Hamilton; Beng-Hoey Jo; Ulf Karlsson; Lexie Smith-Raymond Journal: Strahlenther Onkol Date: 2011-06-28 Impact factor: 3.621
Authors: Alfredo E Romero-Rojas; Julio A Diaz-Perez; Melina Mastrodimos; Jose Szelezsan; Oscar Messa-Botero Journal: Int Ophthalmol Date: 2013-09-13 Impact factor: 2.031
Authors: Timothy E Ortlip; Virginia E Drake; Prashant Raghavan; John C Papadimitriou; Neil C Porter; David J Eisenman; Ronna Hertzano Journal: Otol Neurotol Date: 2017-08 Impact factor: 2.311