[The role of radiotherapy in Graves' ophthalmopathy]

Radiotherapy is a well-established method of treatment for Graves' ophthalmopathy. The main rationale is its anti-inflammatory effect and the high radiosensitivity of T lymphocytes and orbital fibroblasts, which are important effectors in the immune reactions characterizing this disorder. Most centers use a dose of 20 Gy, ten daily doses of 2 Gy given over a period of 2 weeks. Overall favorable responses have been reported in 60% of cases. The best responses were noted for inflammatory signs and recent onset of extraocular muscle involvement. Radiotherapy is well tolerated and safe. A careful selection of patients is necessary. New randomized studies will have to evaluate new radiotherapy protocols with or without corticosteroids or medical immunosuppression.