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Ocular adnexal marginal zone B-cell lymphoma: the low-dose dilemma
  1. Vincent Camus,
  2. Fabrice Jardin,
  3. Hervé Tilly
  1. Department of Hematology, Centre Henri Becquerel, Rouen, France
  1. Correspondence to Dr Vincent Camus, Department of Hematology, Centre Henri Becquerel, Rouen 76038, France; vincent.camus{at}

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The recent publication by Hindso et al1 confirmed the excellent outcome of extranodal marginal zone B-cell lymphoma of the ocular adnexa (OA-EMZL) with external beam radiation therapy (EBRT) as a stand-alone therapy, with an impressive 95% rate of 10-year disease-free survival. In the largest study to date of OA-EMZL patients from seven eyes cancer centres, 352 patients received EBRT as first treatment of localised disease with a median radiation dose of 26 Grays (Gy) (range 4–60 Gy) and the authors concluded that low-dose EBRT would appear to be the best treatment of choice in localised OA-EMZL.1 This important study does not display data regarding the number of patients that received the very low-dose radiation therapy (VLDRT) of 4 Gy. It would also be interesting to report long-term effects based on the dose received. These elements are required to discuss the benefit of low-dose EBRT because of the unfavourable prognosis of the relapses of these OA-EMZL1 and the risk of cataract formation.2 The risk of cataract was associated with delivered dose >30 Gy and omitted …

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