The Role of Radiotherapy in Indolent Ocular Adnexal and Orbital Lymphomas

Background: This study evaluates the oncological outcomes and toxicities of indolent ocular adnexal and orbital lymphomas (OOLs) treated with radiotherapy (RT) ± systemic therapy. Methods: A retrospective analysis of 44 patients with indolent OOLs treated with RT was conducted. Results: Most patients (87%) had early-stage disease. Treatment involved RT alone (34%) or RT + systemic therapy (66%). The median RT dose was 30 Gy, with a median follow-up of 45 months. Local and systemic recurrence rates were 4% and 9%, respectively. Five-year overall and disease-free survival (DFS) rates were 96.2% and 83.6%. Early-stage patients showed similar DFS rates regardless of whether they received RT alone or RT plus systemic therapy. No grade 3 RT-related toxicity occurred, but systemic therapy led to grade 3 toxicity in 17% of patients. Conclusions: RT is essential for treating indolent OOLs, and combination with systemic therapies does not enhance outcomes for early-stage patients.