This study evaluated the efficacy and safety of 20.0 Gy versus 30.6 Gy radiotherapy for conjunctival MALT lymphoma in 76 lesions treated between 2010 and 2022. The 30.6 Gy group showed a shorter median time to response (3.7 vs. 9.5 months, < 0.001) and a higher complete response rate at 6 months (68.4% vs. 36.8%, = 0.009). However, both doses achieved 100% local control at two years. Radiation-induced complications were minimal, with no grade 3 or higher events, and cataracts occurred in only 5.3% of patients in both groups. These results indicate that reducing the radiation dose to 20.0 Gy can achieve comparable long-term outcomes with minimal toxicity, offering an effective treatment alternative for localized conjunctival MALT lymphoma.
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