Radiotherapy for Graves' orbitopathy: randomised placebo-controlled study

Mourits, Maarten P.; Kempen-Harteveld, M. Loes van; García, Marc; Koppeschaar, H. P. F.; Tick, Lidwine W.; Terwee, Caroline B.

doi:10.1016/s0140-6736(00)02165-6

Cited by 259 publications

(165 citation statements)

References 25 publications

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“…However, only in the stu dy performed by Marcocci et al, (14) there was significant difference between the two modalities of treatment. Five studies investigated the lid width (9,10,12,14,15) again Marcocci et al, (14) was the only study to demonstrate significant difference. The visual acuity was evaluated in three RCTs, (12,13,16) only one trial (13) showed benefit for RT 20 Gy arms.…”

Section: Study Characteristicsmentioning

confidence: 95%

“…B. 3 studies (190 patients) tested the efficacy of external beam irradiation compared with shamirradiation (9,10,15) . C. 1 study (82 patients) assessed the efficacy and safety of orbital radiotherapy combined with either oral glucocorticoid or iv glucocorticoids (14) .…”

Section: Study Characteristicsmentioning

confidence: 99%

“…F. 1 study (30 patients) compared the efficacy of combined the rapy RT plus systemic glucocorticoids plus and radiotherapy alone (13) . The studies had a randomized design with 209 patients submitted to RT with or without glucocorticoids and 230 patients submitted to other treatment (9,10,1216) . The parameters evaluated in these stu dies were: Quality of life, costs, proptosis, visual acuity, diplopia, intraocular pressure, optic neuropathy, ocular motility and clinical response.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…The parameters evaluated in these stu dies were: Quality of life, costs, proptosis, visual acuity, diplopia, intraocular pressure, optic neuropathy, ocular motility and clinical response. Seven studies included in this review tested the efficacy of RT 20 Gy to improve proptosis (9,10,12,1416) . However, only in the stu dy performed by Marcocci et al, (14) there was significant difference between the two modalities of treatment.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…The visual acuity was evaluated in three RCTs, (12,13,16) only one trial (13) showed benefit for RT 20 Gy arms. Diplopia was assessed in five RCTs (9,10,12,14,15) of these studies Prummel et al, (15) and Mourits et al (9) founded significant differences between radiotherapy versus sham radiotherapy for changes in diplopia, in the other studies it was not seen. Intraocular pressure was tested in two RCTs (12,16) , one performed by Ng et al (16) , and another by Kahaly et al (12) , in both studies no benefit was seen in combined orbital irradiation and systemic steroids or using low dose of radiotherapy.…”

Section: Study Characteristicsmentioning

confidence: 99%

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Radiation therapy for Graves' ophthalmopathy: a systematic review and meta-analysis of randomized controlled trials

Viani¹,

Boin²,

Fendi³

et al. 2012

Arq. Bras. Oftalmol.

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Purpose: To evaluate the efficacy of radiotherapy (RT) with total dose of 20 Gy (RT 20 Gy) in the treatment of Graves' ophthalmopathy. Methods: A systematic review and metaanalysis of randomized controlled trials was performed comparing RT 20 Gy with or without glucocorticoid to cli nical treatments for Graves' ophthalmopathy. The MEDLINE, EMBASE, Cochrane Library databases and recent relevant journals were searched. Relevant reports were reviewed by two reviewers. Response to radiotherapy was defined as clinical success according to each trial. We also evaluated the quality of life and whether RT to produce fewer side effects than other treatments. Results: A total of 8 randomized controlled trials (439 patients) were identified. In the subgroup analysis, the overall response to treatment rates was better for: RT 20 Gy plus glucocorticoid vs glucocorticoids alone, OR=17.5 (CI95% 1.85250, p=0.04), RT 20 Gy vs sham RT, OR= 3.15 (CI95%1.596.23, p=0.003) and RT 20Gy plus intravenous glucocorticoid vs RT 20Gy plus oral glucocorticoid, OR=4.15(CI95% 1.3412.87, p=0.01). There were no differences between RT 20 Gy versus other fractionations and RT 20 Gy versus glucocorticoid alone. RT 20 Gy with or without glucocorticoids showed an improvement in diplopia grade, visual acuity, optic neuropathy, lid width, proptosis and ocular motility. No difference was seen for costs, intraocular pressure and quality of life. Conclusion: Our data have shown that RT 20 Gy should be offered as a valid the rapeutic option to patients with moderate to severe ophthalmopathy. The effecti veness of orbital radiotherapy can be increased by the synergistic interaction with glucocorticoids. Moreover, RT 20 Gy is useful to improve a lot of ocular symptoms, excluding intraocular pressure, without any difference in quality of life and costs.

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Section: Study Characteristicsmentioning

confidence: 95%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

See 3 more Smart Citations

Radiation therapy for Graves' ophthalmopathy: a systematic review and meta-analysis of randomized controlled trials

Viani¹,

Boin²,

Fendi³

et al. 2012

Arq. Bras. Oftalmol.

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Orbital radiotherapy for adult thyroid eye disease

Rajendram

Bunce

Lee

et al. 2008

Cochrane Database of Systematic Reviews

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Orbital radiotherapy for adult thyroid eye disease

Rajendram

Bunce

Lee³

et al. 2012

Cochrane Database of Systematic Reviews

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This review found that orbital radiotherapy is more effective than sham radiotherapy for the treatment of mild-to-moderate thyroid eye disease. In a single trial no difference between radiotherapy and steroid monotherapy was found. A meta-analysis of our secondary outcome of disease severity was not possible but results from individual trials suggest a better outcome with combination treatment with steroids versus steroids alone. No significant changes in quality-of-life scores following treatment with radiotherapy versus alternative treatments were found. Short-term adverse events related to radiotherapy that were reported were local and mild but long-term data were lacking and development of retinal changes following radiotherapy was not reported on.

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Radiotherapy for Graves' orbitopathy: randomised placebo-controlled study

Cited by 259 publications

References 25 publications

Radiation therapy for Graves' ophthalmopathy: a systematic review and meta-analysis of randomized controlled trials

Radiation therapy for Graves' ophthalmopathy: a systematic review and meta-analysis of randomized controlled trials

Orbital radiotherapy for adult thyroid eye disease

Orbital radiotherapy for adult thyroid eye disease

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