Management of Graves' ophthalmopathy by radiotherapy: A literature review.
Fiche publication
Date publication
juin 2024
Journal
Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique
Auteurs
Membres identifiés du Cancéropôle Est :
Pr TRUC Gilles, Dr BOUSTANI Jihane
Tous les auteurs :
Beige A, Boustani J, Bouillet B, Truc G
Lien Pubmed
Résumé
Orbital radiotherapy for Graves' ophthalmopathy is an example of non-oncological radiotherapy. First introduced in the 1930s, this treatment has become widely used since the 1980s with several studies showing proof of both effectiveness and safety: a decrease of soft tissue involvement in 70 to 80% of patients and an improvement of ocular mobility in 30 to 80% of patients. Nowadays, it's one of the second line treatment options recognized by the European Group on Graves' orbitopathy in the management of a moderate to severe and active disease after failure of glucocorticoids. In that setting, orbital radiotherapy should be combined with glucocorticoids. To our knowledge, there are no practical recommendations on how orbital radiotherapy should be planned and conducted for Graves' ophthalmopathy. Optimal dose is not defined however the most frequent regimen consists of 20Gy in ten fractions of 2Gy, though other options may yield better results. Lastly, the use of modern technique of radiotherapy such as intensity-modulated radiation therapy may allow a better sparing of organs at risk compared to three-dimensional radiotherapy using lateral opposing fields.
Mots clés
Graves’ disease, Graves’ ophthalmopathy, Maladie de Basedow, Orbitopathie de Basedow, Radiotherapy, Radiothérapie
Référence
Cancer Radiother. 2024 06 20;: