S518
Clinical - Haemotology
ESTRO 2026
Digital Poster 4155 Clinical outcomes following radiotherapy for low- grade orbital lymphoma in Sussex Wahyu Wulaningsih, Francesca Wright, Simon Page, Ashok Nikapota Sussex Cancer Centre, Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom Purpose/Objective: To assess clinical outcomes following radiotherapy in low-grade orbital lymphoma. Material/Methods: We evaluated data on patients diagnosed who were treated with radiotherapy for primary or secondary orbital lymphoma between May 2012 and December 2024 across 3 hospitals in Sussex. Patients who had high-grade lymphoma or orbital metastasis from other solid tumours were excluded. Information on demographics, clinical baseline characteristics, radiotherapy data and outcomes including toxicity were obtained from linked electronic medical records. Overall survival (OS) and progression-free survival (PFS) were assessed with Kaplan-Meier curves from the time patients completed radiotherapy to death, disease progression, or last follow-up date. Results: A total of 41 patients with low-grade orbital lymphoma were included, among which 15 (36.6%) died during a median follow-up of 42 months (range 1 – 157 months). Mean age was 74 years at the time of treatment. The predominant histopathological type was marginal zone lymphoma as found in 25 (61%) patients (Table 1). Most patients had stage I disease (75.6%) and received low dose radiotherapy at 4Gy/2# (70.7%). Post-radiotherapy dry eye and cataract were noted in 8 (19.5%) patients each. No grade 3 toxicity following radiotherapy was documented. Median PFS was 71 months with median OS not reached (Figure 1). Three patients (7.3%) experienced local failure. In 2 patients this was as part of their overall stage 4 follicular and Mantle cell lymphoma progression respectively, and one with stage 1 marginal zone orbital relapse.
Hospital of Cologne, University of Cologne, Cologne, Germany. 2 Department of Radiation Oncology, Marienhospital Herne, Ruhr University Bochum, Bochum, Germany Purpose/Objective: Autologous stem-cell transplantation (ASCT) and whole-brain radiotherapy (WBRT) are effective consolidation strategies after induction chemoimmunotherapy for CNS lymphoma, whereas ASCT is increasingly preferred due to lower risks of delayed neurotoxicity. In case of residual lesions after ASCT, additional consolidation radiotherapy (cRT) is often applied, though data remain limited. Material/Methods: We performed a monocentric retrospective analysis of patients treated with RT after induction chemoimmunotherapy and ASCT for either primary CNS lymphoma or secondary CNS lymphoma involvement. Therapy response and disease progression were assessed using magnetic resonance
imaging. Results:
From 2009 to 2024, a total of 84 patients with CNS lymphoma were treated with radiotherapy at our institute, of which12 patients underwent cRT due to residual lesions after ASCT. Five additional patients were initially managed with observation after partial response to ASCT but later received salvage WBRT due to disease progression (median, 5 months after ASCT). Of the 12 cRT treatments, nine were focal RT (mostly 40 Gy in 20 fractions), and the remaining three were WBRT. The median follow-up after cRT was 22 months (range, 4 - 113 months). A local response after cRT was documented in 11 of 12 patient with one patient lost to follow-up. One in-field relapse occurred six months after focal cRT. Four patients died after a median of 27 months (range, 19 – 31 months) without available data regarding cause of death. Among the five patients treated with salvage WBRT due to progression after observation, three received concurrent systemic therapy. A local response after salvage therapy was documented in two patients. Four of these five patients died after a median of 2 months (range, 1-7 months). Conclusion: Consolidation RT for residual lesions after ASCT appears to be an effective approach in patients with CNS lymphoma. In contrast, the outcome of salvage RT applied after disease progression following a partial response to ASCT was poor. Focal cRT may represent a suitable treatment option in most cases, given the high rates of disease control. Keywords: CNS lymphoma, consolidation, focal radiotherapy
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