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Weissmann T, Lettmaier S, Donaubauer AJ, et al. Low- vs. high-dose radiotherapy in Graves' ophthalmopathy: a retrospective comparison of long-term results. Strahlenther Onkol. 2021;197(10):885-894doi: 10.1007/s00066-021-01770-9.
Weissmann, T., Lettmaier, S., Donaubauer, A. J., Bert, C., Schmidt, M., Kruse, F., Ott, O., Hecht, M., Fietkau, R., Frey, B., & Putz, F. (2021). Low- vs. high-dose radiotherapy in Graves' ophthalmopathy: a retrospective comparison of long-term results. Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al], 197(10), 885-894. https://doi.org/10.1007/s00066-021-01770-9
Weissmann, Thomas, et al. "Low- vs. high-dose radiotherapy in Graves' ophthalmopathy: a retrospective comparison of long-term results." Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] vol. 197,10 (2021): 885-894. doi: https://doi.org/10.1007/s00066-021-01770-9
Weissmann T, Lettmaier S, Donaubauer AJ, Bert C, Schmidt M, Kruse F, Ott O, Hecht M, Fietkau R, Frey B, Putz F. Low- vs. high-dose radiotherapy in Graves' ophthalmopathy: a retrospective comparison of long-term results. Strahlenther Onkol. 2021 Oct;197(10):885-894. doi: 10.1007/s00066-021-01770-9. Epub 2021 Apr 16. PMID: 33860819; PMCID: PMC8458186.
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Strahlenther Onkol. 2021 Oct;197(10):885-894. doi: 10.1007/s00066-021-01770-9. Epub 2021 Apr 16.

Low- vs. high-dose radiotherapy in Graves' ophthalmopathy: a retrospective comparison of long-term results.

Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]

Thomas Weissmann, Sebastian Lettmaier, Anna-Jasmina Donaubauer, Christoph Bert, Manfred Schmidt, Friedrich Kruse, Oliver Ott, Markus Hecht, Rainer Fietkau, Benjamin Frey, Florian Putz

Affiliations

  1. Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitaetsstraße 27, 91054, Erlangen, Germany.
  2. Translational Radiation Biology, Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitaetsstraße 27, 91054, Erlangen, Germany.
  3. Department of Ophthalmology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Schwabachanlage 6, 91054, Erlangen, Germany.
  4. Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitaetsstraße 27, 91054, Erlangen, Germany. [email protected].

PMID: 33860819 PMCID: PMC8458186 DOI: 10.1007/s00066-021-01770-9

Abstract

PURPOSE: Radiotherapy represents an effective treatment option in Graves' ophthalmopathy (GO), leading to palliation of clinical symptoms. However, there are only a limited number of trials comparing the effectiveness of low- vs. high-dose radiotherapy.

METHODS: We analyzed 127 patients treated with radiotherapy for stage 3/4 GO (NOSPECS classification). Patients were treated with single doses of 2.0 Gy (cumulative dose 20 Gy) until 2007, afterwards a single dose of 0.8 Gy (cumulative dose 4.8 Gy) was applied. With a median follow-up-time of 9.0 years, the treatment efficacy (overall improvement, sense of eye pressure, lid edema, ocular motility, exophthalmos, subjective vision, and diplopia) and adverse effects were analyzed by a standardized survey.

RESULTS: Overall, 63.8% described improvement of symptoms after radiotherapy. No significant differences in overall treatment response and improvement of main outcome measures between low- or high-dose radiotherapy treatments are detectable, while low-dose radiotherapy leads significantly more often to retreatment (13.1% vs. 1.7%, p = 0.016). The main independent predictor of treatment response is the presence of lid edema (odds ratio, OR, 3.53; p = 0.006).

CONCLUSION: At long-term follow-up, the majority of patients reported palliation of symptoms with limited adverse effects, suggesting clinical effectiveness of radiotherapy for amelioration of GO symptoms independent of low- or high-dose radiotherapy.

© 2021. The Author(s).

Keywords: Exophthalmos; Graves’ ophthalmopathy; Low dose radiation therapy; Radiotherapy; Thyroid eye disease

References

  1. Strahlenther Onkol. 2015 Sep;191(9):742-9 - PubMed
  2. Lancet. 2000 Apr 29;355(9214):1505-9 - PubMed
  3. Med Phys. 2018 Oct;45(10):4775-4782 - PubMed
  4. Br J Ophthalmol. 1998 Jul;82(7):773-9 - PubMed
  5. Radiat Oncol. 2017 Nov 6;12(1):171 - PubMed
  6. J Clin Endocrinol Metab. 2004 Jan;89(1):15-20 - PubMed
  7. Ophthalmology. 2002 Nov;109(11):2100-7 - PubMed
  8. Hong Kong Med J. 2005 Oct;11(5):322-30 - PubMed
  9. Int J Radiat Oncol Biol Phys. 1999 Mar 1;43(4):805-15 - PubMed
  10. Saudi J Ophthalmol. 2011 Jan;25(1):3-13 - PubMed
  11. Clin Exp Immunol. 2015 Jan;179(1):50-61 - PubMed
  12. Radiother Oncol. 1996 Jan;38(1):69-71 - PubMed
  13. Int J Radiat Biol. 2004 Feb;80(2):115-23 - PubMed
  14. Eur Thyroid J. 2018 Aug;7(4):167-186 - PubMed
  15. Ophthalmology. 1990 May;97(5):636-41 - PubMed
  16. Klin Monbl Augenheilkd. 2016 Dec;233(12):1385-1407 - PubMed
  17. Lancet. 1993 Oct 16;342(8877):949-54 - PubMed
  18. Klin Monbl Augenheilkd. 1989 Jul;195(1):1-6 - PubMed
  19. Int J Radiat Oncol Biol Phys. 2003 Jan 1;55(1):182-9 - PubMed
  20. Strahlenther Onkol. 2003 Jun;179(6):372-6 - PubMed
  21. Ophthalmology. 2008 Feb;115(2):398-409 - PubMed
  22. J Clin Endocrinol Metab. 2000 Jan;85(1):102-8 - PubMed
  23. Best Pract Res Clin Endocrinol Metab. 2012 Jun;26(3):339-58 - PubMed
  24. Radiat Oncol. 2009 Nov 23;4:57 - PubMed
  25. J Ocul Biol Dis Infor. 2009 Oct 6;3(1):1-11 - PubMed
  26. J Ophthalmol. 2015;2015:249125 - PubMed
  27. N Engl J Med. 2010 Feb 25;362(8):726-38 - PubMed
  28. Thyroid. 2007 Oct;17(10):1013-8 - PubMed
  29. Orphanet J Rare Dis. 2017 Apr 20;12(1):72 - PubMed
  30. Strahlenther Onkol. 2015 Apr;191(4):295-302 - PubMed
  31. Ophthalmology. 1984 Jul;91(7):770-9 - PubMed
  32. Strahlenther Onkol. 2006 Aug;182(8):431-6 - PubMed

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