Olivotto I A, Ludgate C M, Allen L H, Rootman J
Int J Radiat Oncol Biol Phys. 1985 Dec;11(12):2085-90. doi: 10.1016/0360-3016(85)90088-4.
A treatment technique employing retrobulbar supervoltage radiotherapy (XRT) in Graves' ophthalmopathy is described. Twenty-eight patients have been treated and followed between 1980-1983. Twenty-six of 28 patients (93%) showed some response, with 19/28 (68%) having a good to excellent response. Four of 28 (14%) had recurrent symptoms post-XRT. Soft tissue signs and symptoms were relieved and disease progression arrested in the majority of patients, but proptosis and ophthalmoplegia responded poorly. High dose corticosteroids have generally been the alternative form of therapy for this disease. Post-XRT, 24/28 (86%) of patients have had no further steroid requirements, and been spared the associated complications. Treatment was well tolerated, with only five patients (18%) demonstrating a transient worsening of symptoms which settled entirely within 2 weeks. No long-term complications have been encountered. Eleven patients had post-XRT CT scans which were compared to pre-treatment scans and clinical response. Nine of 11 patients (82%) had CT changes in general agreement with the observed clinical response, but the degree of involvement seen on the initial CT scan was not predictive of response nor the risk of relapse. XRT with the described technique is felt to be an effective, safe, and practical approach to the disabling and disfiguring complications of severe Graves' ophthalmopathy.
本文描述了一种在格雷夫斯眼病中采用球后超高压放射治疗（XRT）的治疗技术。1980年至1983年间，对28例患者进行了治疗并随访。28例患者中有26例（93%）出现了一些反应，其中19/28（68%）有良好至优秀的反应。28例中有4例（14%）在XRT后出现复发症状。大多数患者的软组织体征和症状得到缓解，疾病进展得到遏制，但眼球突出和眼肌麻痹反应不佳。高剂量皮质类固醇通常是这种疾病的替代治疗形式。XRT后，24/28（86%）的患者不再需要类固醇，并避免了相关并发症。治疗耐受性良好，只有5例患者（18%）出现症状短暂恶化，但在2周内完全缓解。未遇到长期并发症。11例患者进行了XRT后的CT扫描，并与治疗前扫描及临床反应进行了比较。11例患者中有9例（82%）的CT变化与观察到的临床反应总体一致，但初始CT扫描所见的受累程度不能预测反应或复发风险。采用所述技术的XRT被认为是一种有效、安全且实用的方法，可用于治疗严重格雷夫斯眼病导致的致残和毁容性并发症。
