Graves ophthalmopathy: MR evaluation of 10-Gy versus 24-Gy irradiation combined with systemic corticosteroids.
OBJECTIVE
To establish the most effective radiation dose for treatment of Graves ophthalmopathy (GO).


METHODS
A combination of 10 Gy (n = 15) or 24 Gy (n = 16) of radiation and corticosteroids was used to treat 31 patients with GO. Magnetic resonance (MR) images obtained before treatment showed swollen extraocular muscles with prolonged T2 relaxation times in all patients.


RESULTS
Before therapy, T2 relaxation time of extraocular muscle was 79.6 msec (95% confidence interval, 76.3, 82.9) in the 24-Gy group and 77.4 msec (95% confidence interval, 74.6, 80.1) in the 10-Gy group (P = .32). After therapy, T2 relaxation time was 62.8 msec (95% confidence interval, 61.2, 64.4) in the 24-Gy group and 68.9 msec (95% confidence interval, 66.8, 71.1) in the 10-Gy group. In the 24-Gy group, there was a significant decrease in T2 relaxation times (P = .001) and clinical response to initial treatment was better. At 1- and 3-month follow-up, the resistance rate was lower in the 24-Gy group.


CONCLUSIONS
In treatment of GO, 24 Gy of radiation is a more effective dose than 10 Gy when combined with systemic corticosteroids.
Nakahara
H
H
Noguchi Thyroid Clinic, Oita, Japan.
Noguchi
S
S
Murakami
N
N
Morita
M
M
Tamaru
M
M
Ohnishi
T
T
Hoshi
H
H
Jinnouchi
S
S
Nagamachi
S
S
Futami
S
S
D003229:Conjunctival Diseases / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy; D004172:Diplopia / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy; D004338:Drug Combinations; D004487:Edema / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy; D005128:Eye Diseases / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D005500:Follow-Up Studies; D006111:Graves Disease / Q000150:complications*; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D009135:Muscular Diseases / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy; D009801:Oculomotor Muscles / Q000187:drug effects / Q000473:pathology / Q000528:radiation effects; D011239:Prednisolone / Q000008:administration & dosage / Q000627:therapeutic use*; D011879:Radiotherapy Dosage; D012008:Recurrence; D012074:Remission Induction
D004338:Drug Combinations; D011239:Prednisolone; D008775:Methylprednisolone