Purpose: Analysis of a series of 50 patients treated by contact x-ray for an eyelid carcinoma.
Methods: From 1980 to 1991, a series of 50 patients with 52 lesions has been included in a protocol of contact x ray for eyelid carcinoma. Median age: 69 years; male: 25; female: 25. Histological or cytological diagnosis showed: basocell carcinoma: 47; squamous cell carcinoma: 5. The site was: lower eyelid; 31, inner canther: 10; outer canther: 5; upper eyelid: 6. Stade was (UICC 1987): T1 (< or = 2 cm): 44; post excision: 8. Treatment was performed on an ambulatory basis with the PHILIPS RT 50 x-ray contact machine (50 KV - 0.5 mm A1). The diameter of the localized was 10 mm: 22; 15 or 20 mm: 30. The standard treatment delivered 42 Gy/7 fractions/4 weeks (1 or 2 fractions of 6 Gy for week).
Results: There was no death due to cancer. A complete response was seen 2 months after the end of treatment in 43/44 cases. A long-term local control was obtained in 47 patients. Loss of eyelash was seen in the irradiated area with a supple and no necroses of the tarsal cartilage. The irradiated skin is slightly depigmented. Stenoses of the lower lacrimal duct is unusual and was seen only if it was in the field of irradiation. No cataract was observed. The cosmetic and functional results appeared excellent in the large majority of patients. One local relapse occurred in the irradiated area and two just outside the irradiated area. These 3 relapses were salvaged, two by surgical excision and one by a subsequent irradiation.
Conclusion: Contact x-ray is a simple technique which requires no hospitalization, neither general anesthesia. It gives excellent local control and good cosmetic results in these small eyelid carcinomas.