格雷夫斯轨道病的放射治疗:随机对照和安慰剂对照的随机研究.
M P Mourits1, M L van Kempen-Harteveld, M B García
1Donders Institute of Ophthalmology (Orbital Unit), University Medical Centre, Utrecht, The Netherlands.
Lancet (London, England)
|May 9, 2000
概括
放射治疗改善了中度严重的Graves轨道病变,特别是运动能力受损的结果,但并没有显著减少proptosis或眼胀. 对于许多患者来说,仍然需要进一步的眼手术.
科学领域:
- 眼科医生 眼科 眼科
- 内分泌学 在内分泌学.
- 辐射瘤学 辐射瘤学
背景情况:
- 格雷夫斯轨道病是一种自我限制的疾病,对于中度严重的疾病来说,最优的治疗方法不确定.
- 目前的治疗方案包括类固醇,辐射或组合疗法.
- 对这种情况的外部光束照射与假照射的疗效需要研究.
研究的目的:
- 评估外部光束照射与模拟照射在中度重度格雷夫斯轨道病变患者的疗效.
- 用定性和定量措施评估治疗结果.
主要方法:
- 一个双盲,随机的临床试验与60名患者进行.
- 患者接受了放射治疗 (20Gy分为10分) 或假辐射.
- 在24周评估结果时,使用主要/次要标准,眼开口,proptosis,眼动和临床活动得分来评估结果.
主要成果:
- 在 60% 的照射患者中,定性结局是成功的,而在假照射患者中,这一比例为 31% (p=0.04).
- 双眼视和眼睛升高的情况有所改善,但不存在亡或眼皮胀.
- 双筒单视野在放射治疗组有所改善,尽管25%仍然需要眼手术.
结论:
- 放射治疗在改善中度严重格雷夫斯轨道病变的某些方面表现出有效性.
- 放射治疗的主要益处似乎是在治疗运动障碍.
- 它的使用应特别考虑在Graves轨道病的运动性问题.
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