K. Tsujino et al., Clinical outcomes of orbital irradiation combined with or without systemichigh-dose or pulsed corticosteroids for Graves' ophthalmopathy, INT J RAD O, 48(3), 2000, pp. 857-864
Citations number
23
Categorie Soggetti
Radiology ,Nuclear Medicine & Imaging","Onconogenesis & Cancer Research
Journal title
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS
Purpose: To evaluate the outcomes of orbital irradiation with or without hi
gh-dose or pulsed corticosteroids in patients with Graves' ophthalmopathy (
GO).
Methods and Materials: One hundred and twenty-one patients,vith moderate to
severe GO who received orbital irradiation from 1987 to 1997 were retrospe
ctively analyzed. A total dose of 20 Gy in 10 fractions was delivered to th
e bilateral retrobulbar volume. Eighty-six patients were treated in combina
tion with high-dose or pulsed corticosteroids and irradiation. Univariate a
nd multivariate analyses were performed to assess the prognostic variables.
Results: The median follow-up period was 26 months. The overall clinical re
sponse was evaluated as excellent in 17 patients (14%), good in 65 (54%), f
air in 31 (25%), no response in 7 (6%), and worse in 1 (1%), The best respo
nses were noted for soft-tissue signs, extraocular muscle involvement, and
sight loss, while a limited response was noted for proptosis, Multivariate
analysis revealed that the use of high-dose corticosteroid or pulsed cortic
osteroids, female gender, and a shorter duration of ophthalmopathy before r
adiotherapy were significantly correlated with favorable outcomes. No long-
term complications related to radiotherapy were observed.
Conclusion: Orbital irradiation combined with high-dose or pulsed corticost
eroids is an effective treatment for moderate to severe GO, especially in c
ases with major manifestations of soft-tissue signs, extraocular muscle imp
airment, or sight loss. (C) 2000 Elsevier Science Inc.