Irradiation of malignant exophthalmos in the course of Graves Basedow disease

Abstract

Summary Aim To present results of irradiation of ophthalmopathy in the course of Graves-Basedow disease performed in the Radiotherapy Laboratory in University Children's Hospital in Cracow by staff of the Oncology Clinic, Collegium Medicum Jagiellonian University (CM UJ). Material and Method During the period of 2000–2003 therapeutic irradiation of the retrobulbar area was performed in 121 patients with malignant exophthalmos using a total dose of 20 Gy/ 10 fractions of 6 MV photonic beam in the Radiotherapy Laboratory in University Children's Hospital in Cracow. Execution of the treatment plan was controlled by in vivo dose measurements using semiconducting detectors, MOSFET type. Radiotherapy was preceded by intravenous corticosteroid therapy (Solu Medrol) with a dose of 2g/ week for 4 weeks. Results During the irradiation treatment 9 patients (7.4%) developed an acute post-radiation reaction of transient character. Ophthalmological control examination revealed an improvement in 97 patients (80.2%) in the form of reduction or total regression of ophthalmopathy symptoms; in 21 other patients (17.3%) stabilization was noted and progression in 3 (2.5%). Conclusions Radiotherapy is a well-tolerated method of ophthalmopathy treatment in the cour se of Graves-Basedow disease. Efficacy of radiotherapy as an exclusive method of malignant exophthalmos treatment seems to be lower in comparison to irradiation combined with corticosteroid therapy.