The effectiveness of proton beam therapy in rare nasolacrimal duct cancers

1. Hiroya Kashiwagi¹
2. Teturo Onizuka²
3. Hiroshi Fuji³
4. Shigeyuki Murayama³

¹Opthalmology in Shizuoka Cancer Center, Nagaizumi, Japan
²Otolaryngology in Shizuoka Cancer Center, Nagaizumi, Japan
³Proton beam therapy section in Shizuoka Cancer Center, Nagaizumi, Japan

Purpose: The aim of this paper is to report the effectiveness of proton beam therapy in nasolacrimal duct cancer.

Methods: Retospective study of two nasolacrimal duct cancers.

Results: Case 1 was a 67-year-old man. The patient noted epiphora of the right eye in 2000. He
was prescribed eye drops; however, the epiphora did not improve. He then noticed a mass of the right inferior eyelid. Computed tomography(CT) revealed the presence of a nasolacrimal duct lesion. A biopsy was performed and the tumor was diagnosed as squamous cell carcinoma.
He and his family refused surgical therapy; hence, chemotherapy was provided and proton beam therapy was performed (total 65GyE) in 2003. The tumor size was reduced, and a follow-up of 8 years showed no recurrence or metastasis. Further, no adverse effects on the eyes were reported.

Case 2 was a 52-year-old woman. The patient noted epiphora of the left eye in 2005. In 2008, she noted a left eye exophthalmos. CT revealed a nasolacrimal tumor, which was diagnosed as an adenoid cystic carcinoma by biopsy. Proton beam therapy (total 70 GyE) was performed in 2009 because she and her family refused surgical intervention. The tumor had a tendency to result in achoresis and exacerbation, and a follow-up of 1 year revealed no metastasis.

Conclusions: Nasolacrimal duct cancer is rare, and the operation medical treatment produces a conditioning the figure-like problem. Hence, we believe that proton beam therapy is an effective
alternative method for surgery in these cancers.