A Randomized Controlled Trial of Orbital Radiotherapy Versus Sham Irradiation in Patients with Mild Graves' Ophthalmopathy
| Autor: | Wilmar M. Wiersinga, Leo E.C.M. Blank, Caroline B. Terwee, M. N. Gerding, Mark F. Prummel, Maarten P. Mourits, Friedo W. Dekker, Lelio Baldeschi |
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| Přispěvatelé: | Epidemiology and Data Science, AII - Inflammatory diseases, APH - Methodology, Ophthalmology, Radiotherapy, Endocrinology, University of Groningen, Damage and Repair in Cancer Development and Cancer Treatment (DARE), Targeted Gynaecologic Oncology (TARGON) |
| Jazyk: | angličtina |
| Rok vydání: | 2004 |
| Předmět: |
medicine.medical_specialty
Eye Diseases Eye Movements Endocrinology Diabetes and Metabolism medicine.medical_treatment Graves' disease Eye disease Clinical Biochemistry OF-LIFE QUESTIONNAIRE Biochemistry DISEASE law.invention Graves' ophthalmopathy DOUBLE-BLIND Endocrinology Randomized controlled trial Double-Blind Method law Internal medicine Surveys and Questionnaires RADIATION-THERAPY medicine MANAGEMENT Humans PERSPECTIVE Diplopia Radiotherapy business.industry Biochemistry (medical) medicine.disease ORBITOPATHY THYROID-ASSOCIATED OPHTHALMOPATHY Graves Disease Surgery Clinical trial Radiation therapy Treatment Outcome Relative risk RELIABILITY Costs and Cost Analysis Quality of Life medicine.symptom business GO-QOL Orbit |
| Zdroj: | Journal of Clinical Endocrinology and Metabolism, 89(1), 15-20. The Endocrine Society Prummel, M F, Terwee, C B, Gerding, M N, Baldeschi, L, Mourits, M P, Blank, L, Dekker, F W & Wiersinga, W M 2004, ' A Randomized Controlled Trial of Orbital Radiotherapy Versus Sham Irradiation in Patients with Mild Graves' Ophthalmopathy ', Journal of Clinical Endocrinology and Metabolism, vol. 89, no. 1, pp. 15-20 . https://doi.org/10.1210/jc.2003-030809 Journal of clinical endocrinology and metabolism, 89(1), 15-20. The Endocrine Society Journal of Clinical Endocrinology and Metabolism, 89(1), 15-20. ENDOCRINE SOC |
| ISSN: | 0021-972X |
| DOI: | 10.1210/jc.2003-030809 |
| Popis: | Radiotherapy is often used in Graves' ophthalmopathy, but its efficacy has been doubted. We compared its efficacy with sham irradiation in mild ophthalmopathy. In a double-blind randomized trial, 44 patients received orbital irradiation, and 44 were sham-irradiated. The primary outcome was assessed using major and minor criteria. As secondary outcome, we used a disease-specific quality of life questionnaire (the GO-QoL) and compared cost-effectiveness and need for follow-up treatment. The primary outcome was successful in 23 of 44 (52%) irradiated patients vs. 12 of 44 (27%) sham-irradiated patients at 12 months after treatment (relative risk, 1.9; 95% confidence interval, 1.1-3.4; P = 0.02). Radiotherapy was effective in improving eye muscle motility and decreasing the severity of diplopia. However, quality of life improved similarly in both groups. In the radiotherapy group there was less need for follow-up treatment; 66% vs. 84% of the patients needed further treatment (P = 0.049). Retrobulbar irradiation did not prevent worsening of ophthalmopathy, which occurred in 14% of the irradiated and 16% of the sham-irradiated patients. Radiotherapy is an effective treatment in mild ophthalmopathy. However, the improvement upon irradiation may not be associated with an increase in quality of life or a reduction in treatment costs. |
| Databáze: | OpenAIRE |
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