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Title: Protracted Hypofractionated Radiotherapy for Graves' Ophthalmopathy: A Pilot Study of Clinical and Radiologic Response

Abstract

Purpose: To evaluate the clinical and radiologic response of patients with Graves' ophthalmopathy given low-dose orbital radiotherapy (RT) with a protracted fractionation. Methods and Materials: Eighteen patients (36 orbits) received orbital RT with a total dose of 10 Gy, fractionated in 1 Gy once a week over 10 weeks. Of these, 9 patients received steroid therapy as well. Patients were evaluated clinically and radiologically at 6 months after treatment. Clinical response assessment was carried out using three criteria: by physical examination, by a modified clinical activity score, and by a verbal questionnaire considering the 10 most common signs and symptoms of the disease. Radiologic response was assessed by magnetic resonance imaging. Results: Improvement in ocular pain, palpebral edema, visual acuity, and ocular motility was observed in all patients. Significant decrease in symptoms such as tearing (p < 0.001) diplopia (p = 0.008), conjunctival hyperemia (p = 0.002), and ocular grittiness (p = 0.031) also occurred. Magnetic resonance imaging showed decrease in ocular muscle thickness and in the intensity of the T2 sequence signal in the majority of patients. Treatments were well tolerated, and to date no complications from treatment have been observed. There was no statistical difference in clinical andmore » radiologic response between patients receiving RT alone and those receiving RT plus steroid therapy. Conclusion: RT delivered in at a low dose and in a protracted scheme should be considered as a useful therapeutic option for patients with Graves' ophthalmopathy.« less

Authors:
 [1];  [2];  [3];  [4]; ;  [1]
  1. Department of Clinical and Experimental Oncology, Division of Radiotherapy, Federal University of Sao Paulo, Sao Paulo, SP (Brazil)
  2. Department of Radiology, Federal University of Sao Paulo, Sao Paulo, SP (Brazil)
  3. Department of Radiotherapy, McGill University Heath Centre, Montreal, Quebec (Canada)
  4. Department of Ophthalmology, Federal University of Sao Paulo, Sao Paulo, SP (Brazil)
Publication Date:
OSTI Identifier:
22056138
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 82; Journal Issue: 3; Other Information: Copyright (c) 2012 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; EDEMA; EYES; FRACTIONATION; MUSCLES; NMR IMAGING; OPHTHALMOLOGY; PAIN; PATIENTS; RADIATION DOSES; RADIOTHERAPY; STEROIDS

Citation Formats

Casimiro de Deus Cardoso, Cejana, Giordani, Adelmo Jose, Borri Wolosker, Angela Maria, Souhami, Luis, Gois Manso, Paulo, Souza Dias, Rodrigo, Comodo Segreto, Helena Regina, and Araujo Segreto, Roberto, E-mail: segreto.dmed@epm.br. Protracted Hypofractionated Radiotherapy for Graves' Ophthalmopathy: A Pilot Study of Clinical and Radiologic Response. United States: N. p., 2012. Web. doi:10.1016/J.IJROBP.2010.09.015.
Casimiro de Deus Cardoso, Cejana, Giordani, Adelmo Jose, Borri Wolosker, Angela Maria, Souhami, Luis, Gois Manso, Paulo, Souza Dias, Rodrigo, Comodo Segreto, Helena Regina, & Araujo Segreto, Roberto, E-mail: segreto.dmed@epm.br. Protracted Hypofractionated Radiotherapy for Graves' Ophthalmopathy: A Pilot Study of Clinical and Radiologic Response. United States. https://doi.org/10.1016/J.IJROBP.2010.09.015
Casimiro de Deus Cardoso, Cejana, Giordani, Adelmo Jose, Borri Wolosker, Angela Maria, Souhami, Luis, Gois Manso, Paulo, Souza Dias, Rodrigo, Comodo Segreto, Helena Regina, and Araujo Segreto, Roberto, E-mail: segreto.dmed@epm.br. 2012. "Protracted Hypofractionated Radiotherapy for Graves' Ophthalmopathy: A Pilot Study of Clinical and Radiologic Response". United States. https://doi.org/10.1016/J.IJROBP.2010.09.015.
@article{osti_22056138,
title = {Protracted Hypofractionated Radiotherapy for Graves' Ophthalmopathy: A Pilot Study of Clinical and Radiologic Response},
author = {Casimiro de Deus Cardoso, Cejana and Giordani, Adelmo Jose and Borri Wolosker, Angela Maria and Souhami, Luis and Gois Manso, Paulo and Souza Dias, Rodrigo and Comodo Segreto, Helena Regina and Araujo Segreto, Roberto, E-mail: segreto.dmed@epm.br},
abstractNote = {Purpose: To evaluate the clinical and radiologic response of patients with Graves' ophthalmopathy given low-dose orbital radiotherapy (RT) with a protracted fractionation. Methods and Materials: Eighteen patients (36 orbits) received orbital RT with a total dose of 10 Gy, fractionated in 1 Gy once a week over 10 weeks. Of these, 9 patients received steroid therapy as well. Patients were evaluated clinically and radiologically at 6 months after treatment. Clinical response assessment was carried out using three criteria: by physical examination, by a modified clinical activity score, and by a verbal questionnaire considering the 10 most common signs and symptoms of the disease. Radiologic response was assessed by magnetic resonance imaging. Results: Improvement in ocular pain, palpebral edema, visual acuity, and ocular motility was observed in all patients. Significant decrease in symptoms such as tearing (p < 0.001) diplopia (p = 0.008), conjunctival hyperemia (p = 0.002), and ocular grittiness (p = 0.031) also occurred. Magnetic resonance imaging showed decrease in ocular muscle thickness and in the intensity of the T2 sequence signal in the majority of patients. Treatments were well tolerated, and to date no complications from treatment have been observed. There was no statistical difference in clinical and radiologic response between patients receiving RT alone and those receiving RT plus steroid therapy. Conclusion: RT delivered in at a low dose and in a protracted scheme should be considered as a useful therapeutic option for patients with Graves' ophthalmopathy.},
doi = {10.1016/J.IJROBP.2010.09.015},
url = {https://www.osti.gov/biblio/22056138}, journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 3,
volume = 82,
place = {United States},
year = {Thu Mar 01 00:00:00 EST 2012},
month = {Thu Mar 01 00:00:00 EST 2012}
}