CyberKnife radiotherapy for orbital metastases: A single-center experience on 24 lesions

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Objectives: To evaluate the feasibility, in terms of acute toxicity and symptom control, of CyberKnife (Accuray, Sunnyvale, CA)-based stereotactic radiotherapy (CyberKnife-SRT) for metastatic orbital lesions. Methods: This retrospective study included patients with symptomatic metastases wholly located within the orbit. Palliative radiation treatment was performed using CyberKnife image-guided technology. Gross tumor volume was defined on a pre-radiotherapy magnetic resonance imaging. Acute and late toxicity was recorded according to Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer Scale. Results: Between April 2012 and July 2016, 21 patients underwent CyberKnife-SRT for 24 orbital metastases from different primary tumors. Median treatment dose was 18 Gy (15–24 Gy) given in a median of 3 fractions (2–3 fractions) with a median dose of 6 Gy/fraction (5–10 Gy/fraction). Acute grade 1 toxicity was observed in eight cases. No local recurrence occurred after median follow-up of 6.2 months (1.1–30.0 months) among 16 lesions that underwent post-stereotactic radiotherapy magnetic resonance imaging. All patients reported decreasing pre-stereotactic radiotherapy symptoms without late toxicity. Follow-up >6 months (median 22.8 months) was available for nine lesions; complete and partial radiological response was registered in four and five of them, respectively. Conclusion: In our experience, CyberKnife-SRT is a well-tolerated treatment that offers high local and symptom control in patients with intraocular and periocular malignant lesions.

Original languageEnglish
Pages (from-to)61-68
Number of pages8
JournalEuropean Journal of Ophthalmology
Issue number1
Publication statusPublished - Jan 1 2019


  • CyberKnife
  • metastases
  • orbital metastases
  • palliative radiotherapy
  • stereotactic radiotherapy

ASJC Scopus subject areas

  • Ophthalmology


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