1,3Holland D., 1,3Kovács N., 2,3Maune S., 3Kovács G., 3,4Mehdorn H. M., 3Galalae R.

1Department of Ophthalmologyl UKK, Hegewischstr. 2, 24105 Kiel, 2ENT department UKK, Arnold-Heller-Str. 14, 24105 Kiel, 3Interdisziplinary Center for Brachytherapy UKK, Arnold-Heller-Str. 9, 24105 Kiel, 4Department of Neuroseurgery UKK, Weimarer Str. 8., 24106 Kiel

Purpose: A new interdisciplinary therapy of malignant orbital tumours and tumours infiltrating the orbit was established at the Orbital Center Kiel in 1993 with the aim of preserving the eye and vision acuity.
Method: Since 1993 11 primary orbital tumours and 14 advanced head tumours infiltrating the orbit were treated. 13 of 25 were tumours relapses. Histological examination showed 11 rhabdomyosarcoma, 7 tumours of the paranasal sinus and nasal cavity, 1 leiomyosarcoma, 1 osteosarcoma, 1 spindle cell carcinoma, 1 basal cell carcinoma, 1 metastasis, 1 meningeoma and 1 inverted papilloma. The median follow up was 31.25 months (range 1-84). The treatment included eye preserving surgical treatment with implantation of plastic tubes for the fractionated postoperative brachytherapy of in average 20 Gy within 5 days. If possible additional percutaneous radiotherapy was performed (average 41 Gy). The type of the surgical treatment was dependent on size and tumour localisation and was performed by an interdisciplinary team.
Results:11/25 patients died of their disease. 6 of these patients died due to local relapse. 14 patients are alive without tumour relapse. No intra- or postoperative complications caused by the implanted plastic tubes were seen. Displacement of the globe and dysfunction of the motility were noted.
Conclusion: The combination of globe and vision preserving surgical treatment with brachytherapy is a useful alternative to orbital exenteration and leads even in a palliative aim to improvement of life quality.

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