Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Int J Radiat Oncol Biol Phys. 2012 Sep 1;84(1):52-8. doi: 10.1016/j.ijrobp.2011.11.031. Epub 2012 Feb 11.
To evaluate the outcomes of patients with idiopathic sclerosing orbital inflammation (ISOI) treated with radiotherapy with or without surgery.
We retrospectively reviewed 22 patients with histopathologically confirmed ISOI who had been refractory or intolerant to steroid therapy and treated with radiation with or without surgery. The radiation dose ranged from 20 to 40 Gy (median, 20 Gy) at 2 Gy per fraction. Presenting signs and treatment outcomes were assessed.
Proptosis was the most common sign at presentation, seen in 19 (86.3%) patients, followed by restriction of extraocular movements in 10 (45.4%) patients. Response to radiotherapy was complete in 15 (68.1%) patients, partial in 3 (13.6%) patients, and none in 4 (18.2%) patients. At the median follow-up of 34 months, 14 (63.6%) patients had progression-free state of symptoms and signs, with the progression-free duration ranging from 3 to 75 months (median, 41.5 months), whereas 8 (36.4%) patients had recurrent or persistent disease although they had received radiotherapy. Of the 14 progression-free patients, 6 underwent a bimodality treatment of debulking surgery of ocular disease and radiotherapy. They had had no recurrent disease. Cataract was the most common late complications, and 2 patients experienced a Grade 3 cataract.
Our study suggests that for patients with ISOI who are refractory or intolerant to steroid therapy, 20 Gy of radiotherapy appears to be effective for the control of disease with acceptable complications, especially when it is combined with surgery.
评估接受放疗联合或不联合手术治疗的特发性硬化性眼眶炎症（ISOI）患者的结局。
我们回顾性分析了 22 例经组织病理学证实的 ISOI 患者，这些患者对类固醇治疗有抵抗或不耐受，接受了放疗联合或不联合手术治疗。放射剂量范围为 20 至 40 Gy（中位数 20 Gy），每次 2 Gy。评估了患者的临床表现和治疗结局。
最常见的首发症状是眼球突出，见于 19 例（86.3%）患者，其次是 10 例（45.4%）患者的眼球运动受限。15 例（68.1%）患者对放疗完全缓解，3 例（13.6%）患者部分缓解，4 例（18.2%）患者无缓解。在中位数为 34 个月的随访中，14 例（63.6%）患者的症状和体征无进展，无进展持续时间为 3 至 75 个月（中位数为 41.5 个月），而 8 例（36.4%）患者尽管接受了放疗，但疾病仍有复发或持续存在。在 14 例无进展患者中，6 例行眼部疾病切除术联合放疗的二模态治疗。他们没有复发疾病。白内障是最常见的晚期并发症，有 2 例患者发生 3 级白内障。
我们的研究表明，对于对类固醇治疗有抵抗或不耐受的 ISOI 患者，20 Gy 的放疗似乎可以有效控制疾病，并发症可接受，特别是与手术联合使用时。
