Jaulerry C
Service de Radiothérapie B, Institut Curie, 26, rue d'Ulm, 75231 Paris.
J Fr Ophtalmol. 2004 Sep;27(7):825-7. doi: 10.1016/s0181-5512(04)96224-9.
Radiotherapy is a well-established method of treatment for Graves' ophthalmopathy. The main rationale is its anti-inflammatory effect and the high radiosensitivity of T lymphocytes and orbital fibroblasts, which are important effectors in the immune reactions characterizing this disorder. Most centers use a dose of 20 Gy, ten daily doses of 2 Gy given over a period of 2 weeks. Overall favorable responses have been reported in 60% of cases. The best responses were noted for inflammatory signs and recent onset of extraocular muscle involvement. Radiotherapy is well tolerated and safe. A careful selection of patients is necessary. New randomized studies will have to evaluate new radiotherapy protocols with or without corticosteroids or medical immunosuppression.
放射治疗是一种成熟的格雷夫斯眼病治疗方法。其主要原理是其抗炎作用以及T淋巴细胞和眼眶成纤维细胞的高放射敏感性,这些细胞是该疾病免疫反应中的重要效应器。大多数中心使用的剂量为20 Gy,在2周内每天给予10次,每次2 Gy。据报道,60%的病例总体反应良好。炎症体征和近期出现的眼外肌受累情况的反应最佳。放射治疗耐受性良好且安全。有必要仔细挑选患者。新的随机研究将必须评估联合或不联合皮质类固醇或药物免疫抑制的新放射治疗方案。