INTRODUCTION
Radiation therapy continues to play an essential role in the management of benign and malignant orbital tumors of children and adults.
MATERIAL AND METHODS
Multidisciplinary perioperative and interstitial interventional radiotherapy (IRT) after extensive but visual acuity preserving tumor resection is reported as safe and well tolerated treatment of advanced/recurrent malignancies involving the intraorbital space and of the skull base. If comparing modern EBRT and IRT technologies, the advantage of IRT was stated also in the adjuvant setting.
RESULTS
Interstitial IRT can be applied as monotherapy or complementary to external beam radiation as a local dose escalation at the external radiation field margins or functionally important sites with micro-, and/or macroscopic residual tumor masses. Nowadays, stepping source techniques with personalized dose planning dominate the field. Visual acuity preservation become possible due to multidisciplinary teamwork in IRT excellence centers of specialized orbita groups. Especially in children intraorbital tumors, surgery combined with intraorbital interventional radiotherapy was proven by several groups as an optimal visual acuity preservation treatment method.
Furthermore, regardless of the invasive character of the treatment, it can be used as adjuvant local treatment following enucleation in cases of extraocular infiltrating melanomas, since the toxicity profile is more advantageous compared to any other modern external beam technique. Additionally, by avoiding exenteration, better cosmetic rehabilitation becomes possible. Although, adjuvant postenucleation EBRT with modern technology has low toxicity rates, review works in the literature advise the use of IRT because of improvements in toxicity results.
CONCLUSION
Interstitial, multidisciplinary IRT plays an important role in visual acuity preservation treatments of intraorbital tumors and offers the lowest toxicity profile in the adjuvant radiotherapy of enucleated extrascleral uveal melanomas.