Should other treatment options be considered for MALT lymphoma if the lacrimal gland will be included in the radiation field in a patient with Sjögren's disease?

The orbit is the second most common site of origin for extranodal marginal zone lymphoma (MZL). Involved orbital structures include the bulbar and/or palpebral conjunctiva, lacrimal gland, and periorbital soft tissues. Patients with Sjögren’s syndrome (SS) are at increased risk for developing extran...

Regular readers of the mednet will recall the ongoing debate about RT dose for curative rx of. localized low-grade lymphomas. While I am generally skeptical of the 2x 200 cgy approach, in this instance, I would use it. Current chemo/immunotherapy approaches are not curative.