https://doi.org/10.31288/oftalmolzh201354650

Results of the treatment of malignant epithelial tumors of the eyelid skin

Safronenkova IA

SI «The Filatov Institute of Eye Diseases and Tissue Therapy NAMS of Ukraine»

Introduction. Among all malignant tumors of the vision, malignant epithelial tumors (MET) of the eyelid skin make up 68—75 %. Treatment of tumors of the eyelid skin has certain peculiarities. Along with the basic principles of oncology — radical and ablation it is necessary to preserve the basic functions — protective, lacrimal and cosmetics. Ignoring these principles leads to inappropriate treatment and, as a consequence — to relapse and need for the mutilation. Purpose. The study of the immediate and long-term results of treatment (radiotherapy + cryoablation) patients with MET of the eyelid skin stage T2b-3b N 0—1M0.

Material and methods. Radiation therapy (RT) followed by cryodestruction (CD), conducted in 590 patients with stage T2b-3b N0 M0 (7patients were with stage T3b N1M0). There were 288 men (48.8 %) aged from19 to 86years old (median= 64.5), women — 302 (51.2 %) aged from 26 to 89 years old (median = 67.5).There were 358 untreated patients (60.7 %), 232 (39.3 %) — with relapses. 394 patients (66.6 %) had basal cell carcinoma, 140 (23.7 %) — squamous and 42 (7.1 %) — metatypical and 12 (2.0 %) — adenocarcinoma. Radiotherapy was applied in the form ofy — RD therapy 2—2.2 Gy, SOD (34.6+5.8) Gy nearfocused X-ray therapy and brachytherapy, RD 40 GR, SOD (288+61.3) Gy.

Immediate results. Of the 590 patients after one course of treatment (RT + CD) complete tumor occurred in 457 cases (77.5 %) in T2b N0 M0 stage — in 247 (54, 1 %), and T3a-3b N0 M0 — in 210 (45.9 %). Partial resorption — in 133 (22.5 %) cases: T2b N0M0stage — in 51 (38.4 %) and T3a-3b N0M0 — in 82 (81.6 %). In 58 (9.8 %) — swelling of the resorbed after re-CD.

Long-term results. When tumors T2b N0 M0 stage recurrences appeared in 27 cases (3.9 %) in the period from 11 to 152 months (median 37 months), and in tumors T3a-3b N0—1M0 — in 34 (5.8 %) in terms rangingfrom 19 to 68.9months (median 33 months). Significantly more (c2 = 5.9, p = 0.01) are marked in ulcer relapse tumor type — 32 (6 %) of the node compared to — 19 (2.3 %).

Conclusion. The use of the first phase of treatment radiotherapy enables to reduce the tumor volume and the CD allows to preserve healthy tissue, skeleton structures of the eyelids and tearful ways. The method can reduce the total radiation dose 1.5—2 times compared with RT in pure form, expand the indications for the treatment of patients with organ-running MET of the eyelid skin T2B-3b N0—1 M0 stage and get a good functional and cosmetic result.

Key words: malignant epithelial tumors of eyelid skin, cryodestruction, radiotherapy

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