방사선종양학

  • [Radiat Oncol.] Efficacy of orbital radiotherapy in moderate-to-severe active graves' orbitopathy including long-lasting disease: a retrospective analysis

    [Radiat Oncol.] Efficacy of orbital radiotherapy in moderate-to-severe active graves' orbitopathy including long-lasting disease: a retrospective analysis

    중앙의대 / 최진화, 이정규*

  • 출처
    Radiat Oncol.
  • 등재일
    2020 Sep 21
  • 저널이슈번호
    15(1):220. doi: 10.1186/s13014-020-01663-8.
  • 내용

    바로가기  >

    Abstract
    Background: We aimed to explore the efficacy of orbital radiotherapy (RT) in patients with moderate-to-severe active Graves' orbitopathy (GO), including long-lasting disease, and to determine the predictive factors associated with treatment response.

    Methods: This was a retrospective study of 62 moderate-to-severe active GO patients treated with RT. Demographic data and ophthalmic findings prior to RT and at 3 and 6 months afterward were analyzed. Computed tomography was performed before and after RT to compare orbital volume change. We used logistic regression to determine the predictive factors for treatment response. Subjects were divided into early- and late-active phase groups based on GO duration of 24 months and treatment outcomes were compared with each other to observe the effects of RT timing on treatment response.

    Results: Forty (64.5%) and forty-six (74.1%) patients experienced improvements in GO at 3 and 6 months after radiotherapy, respectively. Ocular parameters such as clinical activity score (CAS), proptosis, extraocular muscle (EOM) limitation, and compressive optic neuropathy (CON) were improved by RT. Volumes of EOM significantly decreased after RT. The enlargement of EOMs and EOM limitation were predictive factors for a good response to RT. At 6 months after RT, 22 (68.8%) patients of late-active phase group exhibited improvement in GO, which is comparable to the number of 24 (80.0%) patients of early-active phase group. In the late-active phase group, CAS, diplopia, and visual acuity were improved significantly, but there was no change in EOM limitation.

    Conclusions: In moderate-to-severe active GO patients, orbital RT may help improve high CAS, proptosis, EOM limitation, and CON. The orbital RT in long-lasting active GO patients may be considered as treatments for the relief of symptoms including high CAS and poor visual acuity.

     

     

     

    Affiliations

    Jin Hwa Choi  1 , Jeong Kyu Lee  2
    1 Department of Radiation Oncology, Chung-Ang University College of Medicine, Seoul, Republic of Korea.
    2 Department of Ophthalmology, Chung-Ang University College of Medicine, Seoul, Republic of Korea. LK1246@gmail.com.

  • 키워드
    Graves’ orbitopathy; Predictive factors; Radiotherapy; Timing.
  • 연구소개
    이 연구는 급성기 중등도 이상의 중증 갑상선 안병증 환자들을 대상으로 시행한 방사선치료의 효과를 평가한 논문입니다. 대상 환자의 74.1%가 방사선치료 6개월 후 증상의 호전을 보였으며 갑상선 안병증의 임상 활성지표(CAS), 안구돌출증, 외안근 운동제한, 시신경 압박 증상이 통계적으로 유의하게 호전되고 외안근의 부피가 통계적으로 유의하게 감소하는 것을 확인하였습니다. 또한 방사선치료의 효과가 없을 것으로 예상 되었던 24개월 이상 장기적인 급성기 환자들에서도 24개월 미만의 단기 급성기 환자들 만큼 방사선치료의 효과가 있었던 것으로 확인되었습니다. 이 연구는 24개월 이상 장기적으로 급성기에 있는 증증 갑상선 안병증 환자들도 갑상선 안병증의 증상 호전을 위해 방사선 치료를 고려해 볼 수 있도록 하는 근거를 마련한 연구입니다.
  • 편집위원

    갑상선안병증에 대한 방사선치료 성적을 분석한 단일기관 후향적 연구. 방사선치료의 효과를 여러 가지 객관적 지표를 이용하여 분석하고, 방사선치료의 반응을 예측할 수 있는 인자를 제시함.

    2020-11-10 09:34:33

  • 덧글달기
    덧글달기
       IP : 3.239.233.139

    등록