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Efficacy of orbital radiotherapy in moderate-to-severe active graves’ orbitopathy including long-lasting disease: a retrospective analysis
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...
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Published in: | Radiation oncology (London, England) England), 2020-09, Vol.15 (1), p.1-8, Article 220 |
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description | 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. Keywords: Graves' orbitopathy, Radiotherapy, Timing, Predictive factors |
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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. Keywords: Graves' orbitopathy, Radiotherapy, Timing, Predictive factors</description><identifier>ISSN: 1748-717X</identifier><identifier>EISSN: 1748-717X</identifier><identifier>DOI: 10.1186/s13014-020-01663-8</identifier><identifier>PMID: 32958019</identifier><language>eng</language><publisher>London: BioMed Central Ltd</publisher><subject>Acuity ; Care and treatment ; Computed tomography ; Development and progression ; Diabetic retinopathy ; Diplopia ; Disease ; Enlargement ; Graves’ orbitopathy ; Health services ; Institutional repositories ; Medical imaging ; Methods ; Muscles ; Optic neuropathy ; Patient outcomes ; Patients ; Predictive factors ; Radiation therapy ; Radiotherapy ; Regression analysis ; Signs and symptoms ; Software ; Steroids ; Thyroid eye disease ; Timing ; Visual acuity</subject><ispartof>Radiation oncology (London, England), 2020-09, Vol.15 (1), p.1-8, Article 220</ispartof><rights>COPYRIGHT 2020 BioMed Central Ltd.</rights><rights>2020. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s) 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c540t-fafa116150d2158e8209913e52846aec799ecb6187afde35a9cc641db39df6f63</citedby><cites>FETCH-LOGICAL-c540t-fafa116150d2158e8209913e52846aec799ecb6187afde35a9cc641db39df6f63</cites><orcidid>0000-0001-9797-9945</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7507623/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2451711010?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,27924,27925,37012,44590,53791,53793</link.rule.ids></links><search><creatorcontrib>Choi, Jin Hwa</creatorcontrib><creatorcontrib>Lee, Jeong Kyu</creatorcontrib><title>Efficacy of orbital radiotherapy in moderate-to-severe active graves’ orbitopathy including long-lasting disease: a retrospective analysis</title><title>Radiation oncology (London, England)</title><description>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. Keywords: Graves' orbitopathy, Radiotherapy, Timing, Predictive factors</description><subject>Acuity</subject><subject>Care and treatment</subject><subject>Computed tomography</subject><subject>Development and progression</subject><subject>Diabetic retinopathy</subject><subject>Diplopia</subject><subject>Disease</subject><subject>Enlargement</subject><subject>Graves’ orbitopathy</subject><subject>Health services</subject><subject>Institutional repositories</subject><subject>Medical imaging</subject><subject>Methods</subject><subject>Muscles</subject><subject>Optic neuropathy</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Predictive factors</subject><subject>Radiation therapy</subject><subject>Radiotherapy</subject><subject>Regression analysis</subject><subject>Signs and symptoms</subject><subject>Software</subject><subject>Steroids</subject><subject>Thyroid eye disease</subject><subject>Timing</subject><subject>Visual acuity</subject><issn>1748-717X</issn><issn>1748-717X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNptksFu1DAQhiMEoqXwApwicU7xxIljc0CqqgKVKnEBiZs1ccZZr7LxYntX2lsfgBfg9XgSvE0FrIR88Hj8_59G9l8Ur4FdAkjxNgJn0FSsZhUDIXglnxTn0DWy6qD79vSf-qx4EeOasablTD0vznitWslAnRc_bqx1Bs2h9Lb0oXcJpzLg4HxaUcDtoXRzufFDrhNVyVeR9hSoRJPcnsox4J7ir_ufi9dvMa2OFjPtBjeP5eTnsZowpuNhcJEw0rsSy0Ap-LilhYIzTofo4svimcUp0qvH_aL4-uHmy_Wn6u7zx9vrq7vKtA1LlUWLAAJaNtTQSpI1Uwo4tbVsBJLplCLTC5Ad2oF4i8oY0cDQczVYYQW_KG4X7uBxrbfBbTActEenHxo-jBpDcmYibereGtuLFm3TUM8k9RmiGmXRIGOQWe8X1nbXb2gwNKeA0wn09GZ2Kz36ve5a1omaZ8CbR0Dw33cUk177XcgvEnXdtNABMGB_VSPmqdxsfYaZjYtGXwkupBSSdVl1-R9VXgNtnPEzWZf7J4Z6MZj8HTGQ_TM4MH0MmV5CpnPI9EPItOS_AfMMyDs</recordid><startdate>20200921</startdate><enddate>20200921</enddate><creator>Choi, Jin Hwa</creator><creator>Lee, Jeong Kyu</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><general>BMC</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-9797-9945</orcidid></search><sort><creationdate>20200921</creationdate><title>Efficacy of orbital radiotherapy in moderate-to-severe active graves’ orbitopathy including long-lasting disease: a retrospective analysis</title><author>Choi, Jin Hwa ; Lee, Jeong Kyu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c540t-fafa116150d2158e8209913e52846aec799ecb6187afde35a9cc641db39df6f63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Acuity</topic><topic>Care and treatment</topic><topic>Computed tomography</topic><topic>Development and progression</topic><topic>Diabetic retinopathy</topic><topic>Diplopia</topic><topic>Disease</topic><topic>Enlargement</topic><topic>Graves’ orbitopathy</topic><topic>Health services</topic><topic>Institutional repositories</topic><topic>Medical imaging</topic><topic>Methods</topic><topic>Muscles</topic><topic>Optic neuropathy</topic><topic>Patient outcomes</topic><topic>Patients</topic><topic>Predictive factors</topic><topic>Radiation therapy</topic><topic>Radiotherapy</topic><topic>Regression analysis</topic><topic>Signs and symptoms</topic><topic>Software</topic><topic>Steroids</topic><topic>Thyroid eye disease</topic><topic>Timing</topic><topic>Visual acuity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Choi, Jin Hwa</creatorcontrib><creatorcontrib>Lee, Jeong Kyu</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>ProQuest Health and Medical</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest Publicly Available Content database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>PubMed Central (Full Participant titles)</collection><collection>Directory of Open Access Journals</collection><jtitle>Radiation oncology (London, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Choi, Jin Hwa</au><au>Lee, Jeong Kyu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Efficacy of orbital radiotherapy in moderate-to-severe active graves’ orbitopathy including long-lasting disease: a retrospective analysis</atitle><jtitle>Radiation oncology (London, England)</jtitle><date>2020-09-21</date><risdate>2020</risdate><volume>15</volume><issue>1</issue><spage>1</spage><epage>8</epage><pages>1-8</pages><artnum>220</artnum><issn>1748-717X</issn><eissn>1748-717X</eissn><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. Keywords: Graves' orbitopathy, Radiotherapy, Timing, Predictive factors</abstract><cop>London</cop><pub>BioMed Central Ltd</pub><pmid>32958019</pmid><doi>10.1186/s13014-020-01663-8</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-9797-9945</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Acuity Care and treatment Computed tomography Development and progression Diabetic retinopathy Diplopia Disease Enlargement Graves’ orbitopathy Health services Institutional repositories Medical imaging Methods Muscles Optic neuropathy Patient outcomes Patients Predictive factors Radiation therapy Radiotherapy Regression analysis Signs and symptoms Software Steroids Thyroid eye disease Timing Visual acuity |
title | Efficacy of orbital radiotherapy in moderate-to-severe active graves’ orbitopathy including long-lasting disease: a retrospective analysis |
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