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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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