How would you approach a patient with early-stage orbital MALT lymphoma with high proliferative index?

High proliferative index is uncommon in MALT lymphoma, seen more often with high grade histologic variants. For localized disease, it would not influence my management recommendations. For orbital MALT lymphoma, 24 Gy in 2 Gy fractions to the orbit. Efforts to shield part of the orbit should be unde...

Local control for indolent lymphoma with 2 x 2 Gy is very good based on this series.

Fasola et al., PMID 23726002.

I am in favor of attempting 2 x 2 Gy and closely monitoring (together with an ophthalmologist) for possible recurrence, which can then be treated with full-dose RT (24-30Gy).

This appro...