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Yeoh CHY, Lee JJR, Lim BXH, Sundar G, Mehta JS, Chan ASY, Lim DKA, Watson SL, Honavar SG, Manotosh R, Lim CHL. The Management of Ocular Surface Squamous Neoplasia (OSSN). Int J Mol Sci 2022; 24:ijms24010713. [PMID: 36614155 PMCID: PMC9821412 DOI: 10.3390/ijms24010713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 12/24/2022] [Accepted: 12/28/2022] [Indexed: 01/03/2023] Open
Abstract
The rise of primary topical monotherapy with chemotherapeutic drugs and immunomodulatory agents represents an increasing recognition of the medical management of ocular surface squamous neoplasia (OSSN), which may replace surgery as the standard of care in the future. Currently, there is no consensus regarding the best way to manage OSSN with no existing guidelines to date. This paper seeks to evaluate evidence surrounding available treatment modalities and proposes an approach to management. The approach will guide ophthalmologists in selecting the most appropriate treatment regime based on patient and disease factors to minimize treatment related morbidity and improve OSSN control. Further work can be done to validate this algorithm and to develop formal guidelines to direct the management of OSSN.
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Affiliation(s)
- Clarice H. Y. Yeoh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
| | - Jerome J. R. Lee
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 639798, Singapore
| | - Blanche X. H. Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 639798, Singapore
- Department of Ophthalmology, National University Health System, Singapore 119228, Singapore
| | - Gangadhara Sundar
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Department of Ophthalmology, National University Health System, Singapore 119228, Singapore
| | - Jodhbir S. Mehta
- Duke-NUS Graduate Medical School, Singapore 169857, Singapore
- Singapore Eye Research Institute, Singapore 169856, Singapore
- Singapore National Eye Centre, Singapore 168751, Singapore
| | - Anita S. Y. Chan
- Duke-NUS Graduate Medical School, Singapore 169857, Singapore
- Singapore Eye Research Institute, Singapore 169856, Singapore
- Singapore National Eye Centre, Singapore 168751, Singapore
- Histopathology, Pathology Department, Singapore General Hospital, Singapore 169608, Singapore
| | - Dawn K. A. Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Department of Ophthalmology, National University Health System, Singapore 119228, Singapore
| | - Stephanie L. Watson
- Save Sight Institute, Discipline of Ophthalmology, Sydney Medical School, The University of Sydney, Sydney, NSW 2000, Australia
| | | | - Ray Manotosh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Department of Ophthalmology, National University Health System, Singapore 119228, Singapore
| | - Chris H. L. Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Department of Ophthalmology, National University Health System, Singapore 119228, Singapore
- Singapore Eye Research Institute, Singapore 169856, Singapore
- School of Optometry and Vision Science, University of New South Wales, Sydney, NSW 2052, Australia
- Correspondence:
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Sarkar A, Mandal R, Daulat Thakur S. Malignancy with benign course – basaloid squamous cell carcinoma: A rare diagnosis. JOURNAL OF CLINICAL OPHTHALMOLOGY AND RESEARCH 2022. [DOI: 10.4103/jcor.jcor_10_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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Nahon-Estève S, Bertolotto C, Picard-Gauci A, Gastaud L, Baillif S, Hofman P, Groulier A, Maschi C, Caujolle JP, Lassalle S, Martel A. Small but Challenging Conjunctival Melanoma: New Insights, Paradigms and Future Perspectives. Cancers (Basel) 2021; 13:5691. [PMID: 34830847 PMCID: PMC8616295 DOI: 10.3390/cancers13225691] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/01/2021] [Accepted: 11/09/2021] [Indexed: 11/16/2022] Open
Abstract
Although its incidence has increased over the last decades, conjunctival melanoma (CM) remains a rare but challenging periocular malignancy. While there is currently no recognized standard of care, "no-touch" surgical excision followed by adjuvant treatments is usually recommended. Despite its small size, managing CM is challenging for clinicians. The first challenge is the high risk of tumour local recurrence that occurs in about one third of the patients. The management of locally advanced CM (≥T2) or multiple recurrences may require mutilating surgeries such as orbital exenteration (OE). The second challenge is the metastatic spread of CM that occurs in about one quarter of patients, regardless of whether complete surgical excision is performed or not. This highlights the infiltrative and highly aggressive behaviour of CM. Recently, attention has been directed towards the use of eye-sparing strategies to avoid OE. Initially, wide conservative surgeries followed by customized brachytherapy or radiotherapy have appeared as viable strategies. Nowadays, new biological insights into CM have revealed similarities with cutaneous melanoma. These new findings have allowed clinicians to reconsider the management of locally advanced CM with "medical" eye-sparing treatment as well as the management of metastatic spread. The aim of this review was to summarize the current and future perspectives of treatment for CM based on recent biological findings.
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Affiliation(s)
- Sacha Nahon-Estève
- Ophthalmology Department, Centre Hospitalier Universitaire de Nice, Université Côte d’Azur, 06000 Nice, France; (S.B.); (C.M.); (J.-P.C.); (A.M.)
- Department of Biology and Pathologies of Melanocytes, Team1, Equipe Labellisée Ligue 2020 and Equipe Labellisée ARC 2019, Centre Méditerranéen de Médecine Moléculaire, INSERM, 06200 Nice, France;
| | - Corine Bertolotto
- Department of Biology and Pathologies of Melanocytes, Team1, Equipe Labellisée Ligue 2020 and Equipe Labellisée ARC 2019, Centre Méditerranéen de Médecine Moléculaire, INSERM, 06200 Nice, France;
| | - Alexandra Picard-Gauci
- Dermatology Department, Centre Hospitalier Universitaire de Nice, Université Côte d’Azur, 06000 Nice, France;
| | - Lauris Gastaud
- Antoine Lacassagne Cancer Centre, Oncology Department, Université Côte d’Azur, 06000 Nice, France;
| | - Stéphanie Baillif
- Ophthalmology Department, Centre Hospitalier Universitaire de Nice, Université Côte d’Azur, 06000 Nice, France; (S.B.); (C.M.); (J.-P.C.); (A.M.)
| | - Paul Hofman
- FHU OncoAge, Institute for Research on Cancer and Aging, Nice (IRCAN), Université Côte d’Azur, 06000 Nice, France; (P.H.); (S.L.)
- Biobank BB-0033-00025, Laboratory of Clinical and Experimental Pathology, Centre Hospitalier Universitaire de Nice, Université Côte d’Azur, 06000 Nice, France
| | - Anaïs Groulier
- Antoine Lacassagne Cancer Center, Department of Radiation Oncology, Université Côte d’Azur, 06000 Nice, France;
| | - Célia Maschi
- Ophthalmology Department, Centre Hospitalier Universitaire de Nice, Université Côte d’Azur, 06000 Nice, France; (S.B.); (C.M.); (J.-P.C.); (A.M.)
| | - Jean-Pierre Caujolle
- Ophthalmology Department, Centre Hospitalier Universitaire de Nice, Université Côte d’Azur, 06000 Nice, France; (S.B.); (C.M.); (J.-P.C.); (A.M.)
| | - Sandra Lassalle
- FHU OncoAge, Institute for Research on Cancer and Aging, Nice (IRCAN), Université Côte d’Azur, 06000 Nice, France; (P.H.); (S.L.)
- Biobank BB-0033-00025, Laboratory of Clinical and Experimental Pathology, Centre Hospitalier Universitaire de Nice, Université Côte d’Azur, 06000 Nice, France
| | - Arnaud Martel
- Ophthalmology Department, Centre Hospitalier Universitaire de Nice, Université Côte d’Azur, 06000 Nice, France; (S.B.); (C.M.); (J.-P.C.); (A.M.)
- FHU OncoAge, Institute for Research on Cancer and Aging, Nice (IRCAN), Université Côte d’Azur, 06000 Nice, France; (P.H.); (S.L.)
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Proton beam radiotherapy of locally advanced or recurrent conjunctival squamous cell carcinoma: experience of the CATANA Centre. JOURNAL OF RADIOTHERAPY IN PRACTICE 2020. [DOI: 10.1017/s1460396920000953] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractAim:Conjunctival squamous cell carcinoma (SCC) is a rare tumour of the ocular region and microscopic radical surgical is difficult. There are no single guidelines for therapeutic management and the role of radiation therapy is not clearly defined although conventionally photon or electron beams are used. Proton beam radiotherapy (PBRT) is a new option for a conservative approach and allows good sparing of the organs at risk.Materials and methods:After surgical resection, we collected 15 cases treated at our institution with PBRT. The dose delivered was between 48 and 60 Gy relative biological effectiveness (RBE), with fractions of 12–15 Gy RBE.Results:After an average period of 48 months, the patients achieved excellent disease control (overall survival and disease-free survival: 86·6%), with minimal acute and late toxicity.Findings:In this work, we present our experience on the use of PBRT technique in SCC treatment. A larger sample of patients is needed to draw conclusions about the impact of this treatment on disease recurrence and overall survival.
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Santoni A, Thariat J, Maschi C, Herault J, Baillif S, Lassalle S, Peyrichon ML, Salleron J, Caujolle JP. Management of Invasive Squamous Cell Carcinomas of the Conjunctiva. Am J Ophthalmol 2019; 200:1-9. [PMID: 30552889 DOI: 10.1016/j.ajo.2018.11.024] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 11/28/2018] [Accepted: 11/30/2018] [Indexed: 11/20/2022]
Abstract
PURPOSE Ocular surface squamous neoplasia includes a spectrum of diseases from dysplasia to invasive squamous cell carcinoma (SCC) of the conjunctiva. Whether the degree of invasion influences outcomes is debated. We evaluated the outcomes and management of conjunctival carcinomas defined as ≤0.2 mm invasion of the chorion (microinvasive; miSCC) or over (SCC). DESIGN Retrospective case series. METHODS Clinical, tumor, and therapeutic characteristics and outcomes were collected for consecutive patients with histology-proven invasive conjunctival miSCC/SCC treated between 2002 and 2017. RESULTS Patients were 70% men, ≥70 years old (56%), with carcinomas of the bulbar conjunctiva (83.0%). Limbal, corneal, and/or scleral involvement were present in 70.4%, 42.6%, and 27.8%, respectively. Patient characteristics, tumor characteristics, and no-touch surgery rates were similar between the 39 SCC and 15 miSCC. However, mitomycin was performed in 93.3% and 20.5% of miSCC and SCC, respectively (P < .001). Proton therapy was performed in 0% and 92.0% of miSCC and SCC, respectively (P < .001). SCC received mitomycin in case of tumoral resection margins, respectively (P = .018). The 24-month incidence of local relapse was 14.8%, including 20% and 12% for miSCC and SCC, respectively (P = .079). Irradiation was the only prognostic factor associated with a lower risk for local relapse (hazard ratio [0.25]; P = .045). There were 2 cancer-related deaths (2%). Mild/moderate anterior segment complications occurred in one third of the patients. CONCLUSIONS miSCC had slightly worse relapse rates compared with SCC. Postoperative proton therapy, performed in SCC only, was associated with a lower risk for relapse.
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Affiliation(s)
- Alexandra Santoni
- Department of Ophthalmology, Pasteur 2 Teaching Hospital, Nice, France
| | - Juliette Thariat
- Department of Radiation Oncology, Francois Baclesse Cancer ARCHADE Center, Normandie Universite-Unicaen, Caen, France.
| | - Célia Maschi
- Department of Ophthalmology, Pasteur 2 Teaching Hospital, Nice, France
| | - Joel Herault
- Department of Radiation Oncology, Antoine-Lacassagne Cancer Center, Nice, France
| | - Stéphanie Baillif
- Department of Ophthalmology, Pasteur 2 Teaching Hospital, Nice, France
| | - Sandra Lassalle
- Department of Biopathology, Pasteur 2 Teaching Hospital, Nice, France
| | | | - Julia Salleron
- Department of Biostatistics, Institut de Cancérologie de Lorraine, Université de Lorraine, Vandœuvre-lès-Nancy, France
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Lassalle S, Caujolle JP, Leger F, Maschi C, Gastaud L, Nahon-Esteve S, Thariat J, Baillif S, Hofman P. [Focus on clinical and pathological management of conjunctival melanocytic tumors]. Ann Pathol 2018; 38:153-163. [PMID: 29803361 DOI: 10.1016/j.annpat.2018.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 03/12/2018] [Accepted: 03/22/2018] [Indexed: 11/26/2022]
Abstract
Conjunctival-pigmented tumors are rare, but they are one of the most commonly encountered by the pathologist working with the department of ophthalmology. Nevus and melanoma can be encountered and have some histological difference compared to their cutaneous counterpart. Primary acquired melanosis (PAM) is a conjunctival specific entity. This clinical term includes several histological lesions ranging from benignity to melanoma precursor lesion. Histologic examination determines the therapy and the risk of progression to melanoma. We present here a histopathological, clinical and therapeutic synthesis of conjunctival-pigmented lesions, emphasizing the importance of a good understanding between clinicians and pathologists.
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Affiliation(s)
- Sandra Lassalle
- Laboratoire de pathologie clinique et expérimentale, pavillon J, hôpital Pasteur, CHU de Nice, 30, voie Romaine, CS 51069, 06001 Nice cedex 1, France; Institute of research on cancer and aging de Nice (IRCAN), Inserm U1081/CNRS UMR7284, UFR de médecine, 28, avenue Valombrose, 06107 Nice cedex 2, France; FHU OncoAge Nice, 30, avenue de la voie Romaine, CS 51069, 06001 Nice cedex 1, France.
| | - Jean-Pierre Caujolle
- Service d'ophtalmologie, hôpital Pasteur 2, CHU de Nice, 30, voie Romaine, CS 51069, 06001 Nice cedex 1, France
| | - François Leger
- Service de pathologie, hôpital Pellegrin, CHU de Bordeaux, 33000 Bordeaux, France
| | - Célia Maschi
- Service d'ophtalmologie, hôpital Pasteur 2, CHU de Nice, 30, voie Romaine, CS 51069, 06001 Nice cedex 1, France
| | - Lauris Gastaud
- Département d'oncologie médicale, centre Antoine-Lacassagne, 33, avenue Valombrose, 06189 Nice, France
| | - Sacha Nahon-Esteve
- Service d'ophtalmologie, hôpital Pasteur 2, CHU de Nice, 30, voie Romaine, CS 51069, 06001 Nice cedex 1, France
| | - Juliette Thariat
- Département de radiothérapie, centre Antoine-Lacassagne, 33, avenue Valombrose, 06189 Nice, France
| | - Stéphanie Baillif
- Service d'ophtalmologie, hôpital Pasteur 2, CHU de Nice, 30, voie Romaine, CS 51069, 06001 Nice cedex 1, France
| | - Paul Hofman
- Laboratoire de pathologie clinique et expérimentale, pavillon J, hôpital Pasteur, CHU de Nice, 30, voie Romaine, CS 51069, 06001 Nice cedex 1, France; Institute of research on cancer and aging de Nice (IRCAN), Inserm U1081/CNRS UMR7284, UFR de médecine, 28, avenue Valombrose, 06107 Nice cedex 2, France; FHU OncoAge Nice, 30, avenue de la voie Romaine, CS 51069, 06001 Nice cedex 1, France
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7
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Coquard R, N'Guyen AM, Mathis T, Josserand-Pietri F, Khodri M, Largeron G, Barbet N, Grange JD. [Adjuvant contact radiotherapy for conjunctival malignancies: Preliminary results of a series of 14 patients treated with the Papillon 50 machine]. Cancer Radiother 2018; 22:107-111. [PMID: 29475731 DOI: 10.1016/j.canrad.2017.08.111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 07/07/2017] [Accepted: 08/02/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE To evaluate the results of an adjuvant contact irradiation using 50kV photons after resection of conjunctival malignancies. MATERIALS AND METHOD From 2012 to 2014, 14 patients (male: nine; female: five) have been treated by contact irradiation after resection of a malignant tumor of the conjunctiva (melanoma: five patients; malignant fibrous histiocytoma: one patient; carcinoma: eight patients) The treatment was performed using the Papillon 50 machine (Ariane). Three to four sessions were delivered, each giving a dose of 10Gy. The median follow-up in survivors was 33 months. RESULTS The tolerance was good. A cataract was seen in one patient, and a moderate eye dryness in one. There was no corneal ulcer. One patient died of intercurrent disease. One patient with carcinoma recurred locally. CONCLUSION Adjuvant contact radiotherapy provides a good local control after resection of conjunctival malignancies (melanoma, malignant histiocytofibroma, carcinoma). Thanks to its precision, this technique is well tolerated with a low rate of complications. Furthermore, it is delivered on an ambulatory basis.
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Affiliation(s)
- R Coquard
- Centre de radiothérapie Bayard, 44, avenue Condorcet, 69100 Villeurbanne, France.
| | - A M N'Guyen
- Service d'ophtalmologie, hôpital de la Croix-Rousse, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France
| | - T Mathis
- Service d'ophtalmologie, hôpital de la Croix-Rousse, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France
| | - F Josserand-Pietri
- Centre de radiothérapie Bayard, 44, avenue Condorcet, 69100 Villeurbanne, France
| | - M Khodri
- Centre de radiothérapie Bayard, 44, avenue Condorcet, 69100 Villeurbanne, France
| | - G Largeron
- Centre de radiothérapie Bayard, 44, avenue Condorcet, 69100 Villeurbanne, France
| | - N Barbet
- Centre de radiothérapie Bayard, 44, avenue Condorcet, 69100 Villeurbanne, France
| | - J D Grange
- Service d'ophtalmologie, hôpital de la Croix-Rousse, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France
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Jardel P, Caujolle JP, Gastaud L, Maschi C, Sauerwein W, Thariat J. [Malignant tumours of the eye: Epidemiology, diagnostic methods and radiotherapy]. Cancer Radiother 2015; 19:762-74. [PMID: 26508321 DOI: 10.1016/j.canrad.2015.04.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 04/23/2015] [Indexed: 12/12/2022]
Abstract
Malignant tumours of the eye are not common, barely representing 1 % of all cancers. This article aims to summarise, for each of the main eye malignant diseases, aspects of epidemiology, diagnostic methods and treatments, with a focus on radiation therapy techniques. The studied tumours are: eye metastasis, intraocular and ocular adnexal lymphomas, uveal melanomas, malignant tumours of the conjunctive, of the lids, and retinoblastomas. The last chapter outlines ocular complications of radiation therapy and their management.
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Affiliation(s)
- P Jardel
- Service d'oncologie radiothérapie, CHU de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France.
| | - J-P Caujolle
- Service d'ophtalmologie, hôpital Saint-Roch, CHU de Nice, 5, rue Pierre-Dévoluy, 06000 Nice, France
| | - L Gastaud
- Service d'oncologie médicale, centre Antoine-Lacassagne, 33, avenue de la Lanterne, 06189 Nice, France
| | - C Maschi
- Service d'ophtalmologie, hôpital Saint-Roch, CHU de Nice, 5, rue Pierre-Dévoluy, 06000 Nice, France
| | - W Sauerwein
- NC Team, Strahlenklinik, hôpital universitaire, 45122 Essen, Allemagne
| | - J Thariat
- Unité CyberKnife et protonthérapie, service d'oncologie radiothérapie, centre Antoine-Lacassagne, 227, avenue de la Lanterne, 06200 Nice, France
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Maschi-Cayla C, Doyen J, Gastaud P, Caujolle JP. Conjunctival melanomas and proton beam therapy. Acta Ophthalmol 2013; 91:e647. [PMID: 23879347 DOI: 10.1111/aos.12202] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Celia Maschi-Cayla
- Department of Ophthalmology, St Roch Hospital, Nice Teaching Hospital, Nice, FranceAntoine Lacassagne Oncology Centre, Radiotherapy, Nice, France
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10
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El-Assal KS, Salvi SM, Rundle PA, Mudhar HS, Rennie IG. Treatment of invasive ocular surface squamous neoplasia with proton beam therapy. Eye (Lond) 2013; 27:1223-4. [PMID: 23907623 DOI: 10.1038/eye.2013.149] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- K S El-Assal
- Department of Ophthalmology, Royal Hallamshire Hospital, Sheffield, UK
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11
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Arend N, Decker C, Messmer EM, Kampik A, Hintschich C. [Invasive squamous cell carcinoma of the conjunctiva]. Ophthalmologe 2012; 110:57-60. [PMID: 22733285 DOI: 10.1007/s00347-012-2578-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
We report the case of a 71-year-old male who was first diagnosed with conjunctival squamous cell carcinoma in September 2010. The lesion was excised twice and cryotherapy of the margins was performed. On histology the margins were not tumor-free but this was not followed up by further excision. After 5 months the patient was referred to this department with a growing tumor mass which had infiltrated into the anterior chamber and partly destroyed the iris. Because of this advanced finding extended enucleation was performed. The histological examination showed a well differentiated squamous cell carcinoma and no evidence of metastasis in lymph nodes or elsewhere could be found by conventional computed tomography (CT) and positron emission CT (PET-CT).
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Affiliation(s)
- N Arend
- Augenklinik der LMU, Klinikum der Universität München, Campus Innenstadt, Mathildenstr. 8, 80336 München.
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Abstract
PURPOSE To describe the authors' technique and preliminary results using electron beam radiation as rescue therapy for recalcitrant squamous cell carcinoma of the conjunctiva and cornea. METHODS A retrospective review comprised of an interventional case series of patients with pathologically confirmed diagnosis of squamous cell carcinoma of the conjunctiva and cornea, who had failed multiple standard treatments and underwent electron beam radiation therapy. Outcomes, radiation-related complications, and adverse effects were documented. Mortality and local control rates were calculated by the Kaplan-Meier survival probability method. RESULTS Eight patients met the inclusion criteria; of these, 6 (75%) were men and 2 (25%) were women, with ages ranging from 38 to 65 years (mean 50 years). One tumor (12.5%) was classified as T2N0M0, 6 (75%) were classified as T3N0M0, and one (12.5%) was classified as T4N0M0. Follow up from electron beam radiation therapy ranged from 3 to 72 months (mean 30.25 months). The most common side effect was erythema and edema of the eyelids with diffuse transient eyelash loss, seen in all patients. Tumor local control and regression after electron beam radiation therapy were noted in 6 patients (75%); recurrence was noted in 2. There was neither metastatic spread nor tumor-related deaths. CONCLUSIONS The authors report a small case series where local tumor control was achieved with electron beam radiation therapy for recalcitrant squamous cell carcinoma of the conjunctiva and cornea. This approach may be considered for patients who fail conventional therapy.
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