Outcome of thyroid associated ophthalmopathy treated by radiation therapy

Abstract

Thyroid associated orbitopathy is a common manifestation of Graves disease. Many options can be considered for treatment. In this case series, we reviewed the medical records of 17 patients who received radiation therapy (RT) for GO in a tertiary care center between 1997 and 2007. All patients received 20 Gy to both orbits and 12 of them (71%) had already received one or more trials of steroid therapy prior to RT. After a median follow-up of 2 years, a subjective improvement in exophthalmos and vision was reported by all patients at the end of RT but only 3 patients reported a decrease in their diplopia immediately after therapy. Symptoms continued to improve with time in many patients: 22% had complete reversal of their symptoms and signs, and the remaining 78% had partial improvement. Two patients developed recurrent signs and symptoms, both of them were smokers who continued to smoke after treatment. About 60-65% of patients responded favorably to RT alone which increased to 87-97% when RT is combined with steroids. No patients developed late toxicity during the follow-up period. We conclude that RT is an effective treatment option in GO even in patients who failed previous treatment with steroids or surgical decompression. Based on our own clinical experiences and the literature data, the combination of RT and intravenous corticosteroid administration may improve the response rate.

Risk Factors Associated with the Activity and Severity of Graves’ Ophthalmopathy among Patients at the University of the Philippines Manila-Philippine General Hospital

“…1 It is the most frequent orbital disorder and is the most common cause of unilateral and bilateral proptosis in adults. [2][3][4] Internationally, it is detectable in approximately 10 to 60% of GD patients.…”

“…1,8 Smokers are estimated to represent 64% of patients with GD and GO. 9 The risk of GO is found to be related to active smoking and is proportional to the number of cigarettes smoked per day.…”

Rola radioterapii oczodołów w leczeniu orbitopatii tarczycowej — aktualny stan wiedzy

“…Dopiero później rozpoczęto napromienianie oczodołu jako pierwotnego miejsca, w którym toczy się proces patologiczny. Pierwszym urządzeniem zastosowanym do radioterapii był aparat ortowoltowy, następnie zastąpiony przez akcelerator liniowy [23,24].…”

“…Later, radiation was correctly applied to the orbital tissue. Firstly, the orthovoltage machine was used, than a linear accelerator was adapted [23,24].…”

Orbital radiotherapy for thyroid eye disease

“…Abboud et al [31] reviewed 17 patients and found 65% responded favorably to radiotherapy alone whereas 87-97% responded when radiotherapy was combined with steroids. Abboud et al [31] reviewed 17 patients and found 65% responded favorably to radiotherapy alone whereas 87-97% responded when radiotherapy was combined with steroids.…”