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Hypofractionated radiotherapy for Graves' orbitopathy.

R Heyd1, G Strassmann, M Herkströter

  • 1Strahlenklinik, Klinikum Offenbach, Offenbach am Main.

Rontgenpraxis; Zeitschrift Fur Radiologische Technik
|January 22, 2002
PubMed
Summary

Hypofractionated radiotherapy effectively treats severe Graves' orbitopathy, even in long-standing cases. This approach shows comparable results to conventional radiotherapy for managing this eye condition.

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Area of Science:

  • Ophthalmology
  • Radiation Oncology

Background:

  • Graves' orbitopathy (GO) is a complex autoimmune condition affecting the eyes.
  • Radiotherapy (RT) is an established treatment for GO, typically using conventional fractionation.
  • The efficacy of hypofractionated RT for GO remains largely unexplored.

Purpose of the Study:

  • To evaluate the effectiveness of hypofractionated radiotherapy in managing severe Graves' orbitopathy.
  • To assess outcomes in patients with treatment-resistant GO previously managed with corticosteroids.

Main Methods:

  • Retrospective analysis of 33 euthyroid patients with Graves' orbitopathy.
  • Treatment involved hypofractionated RT: 21.0 Gy in 3 weekly fractions of 3.0 Gy.
  • Patients had symptom duration of 1-84 months and prior corticosteroid treatment failure.
  • Outcomes assessed using Donaldson criteria and a clinical classification (eyelid changes, exophthalmos, myopathy, optic neuropathy) after a mean 33.6-month follow-up.

Main Results:

  • Overall treatment response rate was 84.8% (28/33 patients).
  • Significant improvement observed in eyelid changes and exophthalmos (57.6%) and myopathy (36.4%).
  • Two patients (6.0%) required surgical decompression due to optic nerve compression.
  • Nine percent (9.0%) were classified as non-responders due to disease progression.

Conclusions:

  • Hypofractionated radiotherapy is an effective treatment for severe Graves' orbitopathy, particularly in patients with prolonged symptoms.
  • Results indicate that hypofractionated RT yields outcomes comparable to conventional fractionated RT.
  • This approach offers a viable alternative for managing refractory Graves' orbitopathy.