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放射性眼病治疗后 1 年的疗效变化、眼部表现和生活质量。

Changes in therapeutic response, ocular manifestations of Graves' orbitopathy and quality of life during the first year after orbital radiotherapy.

机构信息

Department of Endocrinology, Medical University of Sofia, University Hospital of Endocrinology, 2 Zdrave Str., 1431, Sofia, Bulgaria.

Department of Radiooncology, Medical University of Sofia, University Hospital "Tsaritsa Yoanna", Sofia, Bulgaria.

出版信息

Int Ophthalmol. 2023 Nov;43(11):4305-4314. doi: 10.1007/s10792-023-02842-8. Epub 2023 Aug 10.

Abstract

PURPOSE

The aim of our study was to assess the changes in the therapeutic response, ocular manifestations of GO and quality of life during the first year after OR.

METHODS

The study involved 26 consecutive patients with active moderate-to-severe GO indicated for OR, 18 females, mean age 57 ± 12.5. At baseline, all patients underwent comprehensive ocular examination and thyroid hormone and antibody testing. Then, OR was performed with a total dose of 20 Gy, divided into 10 sessions of 2 Gy each with concomitant oral intake of low-dose glucocorticoids. Therapeutic response and individual ocular manifestations were evaluated 1, 3, 6 and 12 months after OR, and QoL-at 3, 6 and 12 months by a disease-specific questionnaire.

RESULTS

One month after OR, 61.6% of patients had a therapeutic response (full or partial). During the follow-up, the proportion of full-responders gradually increased up to 57.5% at 12 months, while that of non-responders gradually decreased, reaching 11.5% at 12 months. All individual ocular manifestations improved significantly 1-3 months after OR. QoL related to visual functioning increased significantly at 6 months, whereas QoL related to appearance improved significantly at 12 months.

CONCLUSIONS

The vast majority of our patients with active moderate-to-severe GO exhibited full or partial therapeutic response after OR. The initial effect on the therapeutic response and individual ocular parameters was evident as soon as 1-3 months after the procedure. OR also has a beneficial effect on patients' QoL.

TRIAL REGISTRATION NUMBER

NCT05775185/07.03.2023, retrospectively registered.

摘要

目的

我们研究的目的是评估在接受 OR 治疗后的第一年中,治疗反应、GO 的眼部表现和生活质量的变化。

方法

本研究纳入了 26 例患有活动期中重度 GO 并需要接受 OR 治疗的连续患者,其中 18 例为女性,平均年龄为 57±12.5 岁。在基线时,所有患者均接受了全面的眼部检查以及甲状腺激素和抗体检测。随后,采用 20 Gy 的总剂量,分为 10 次,每次 2 Gy,并同时口服低剂量糖皮质激素。在 OR 治疗后 1、3、6 和 12 个月评估治疗反应和个体眼部表现,并在 3、6 和 12 个月通过疾病特异性问卷评估生活质量。

结果

OR 治疗后 1 个月,61.6%的患者有治疗反应(完全或部分)。在随访期间,完全反应者的比例逐渐增加,到 12 个月时达到 57.5%,而无反应者的比例逐渐减少,到 12 个月时达到 11.5%。所有个体眼部表现均在 OR 治疗后 1-3 个月显著改善。与视觉功能相关的生活质量在 6 个月时显著增加,而与外观相关的生活质量在 12 个月时显著改善。

结论

我们的大多数患有活动期中重度 GO 的患者在接受 OR 治疗后表现出完全或部分治疗反应。治疗反应和个体眼部参数的初始效果在治疗后 1-3 个月即可显现。OR 还对患者的生活质量有有益的影响。

试验注册号

NCT05775185/07.03.2023,回顾性注册。

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