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.