BACKGROUND: Graves' ophthalmopathy is the commonest extrathyroidal manifestation of Graves' disease. Treatment options include steroid therapy, corrective/decompressive surgery, radiation therapy or combination of these approaches. AIM: Our purpose was to investigate if retro-orbital irradiation with Volumetric Modulated Arc Therapy (VMAT) yielded better target coverage and dose sparing to adjacent normal structures compared to 3-Dimensional Conformal Radiotherapy (3DCRT) and Lateral Opposing Conformed Fields (LOCF). METHODS: Fourteen consecutive patients diagnosed with bilateral Graves' ophthalmopathy were prospectively recruited into this study from August 2012 until August 2014. An individual VMAT, 3DCRT and LOF plan was created for each patient. Conformity Index (CI), Homogeneity Index (HI) and other dosimetric parameters of the targets and organs-at-risk (OAR) were analyzed in all 28 orbits compared between the different techniques. RESULTS: CI generated by VMAT was superior to that produced by 3DCRT(p < .001) and LOF (p < .001). As expected, 3DCRT was also superior to LOF (p = .007). Regarding the OARs sparing dose (lens, globes, retina and lacrimal glands), VMAT showed a significant benefit when compared with 3DCRT and LOCF, with no differences between the two latter techniques. CONCLUSIONS: VMAT should be preferred over 3DCRT and LOF for bilateral Graves' ophthalmopathy treatment.
BACKGROUND:Graves' ophthalmopathy is the commonest extrathyroidal manifestation of Graves' disease. Treatment options include steroid therapy, corrective/decompressive surgery, radiation therapy or combination of these approaches. AIM: Our purpose was to investigate if retro-orbital irradiation with Volumetric Modulated Arc Therapy (VMAT) yielded better target coverage and dose sparing to adjacent normal structures compared to 3-Dimensional Conformal Radiotherapy (3DCRT) and Lateral Opposing Conformed Fields (LOCF). METHODS: Fourteen consecutive patients diagnosed with bilateral Graves' ophthalmopathy were prospectively recruited into this study from August 2012 until August 2014. An individual VMAT, 3DCRT and LOF plan was created for each patient. Conformity Index (CI), Homogeneity Index (HI) and other dosimetric parameters of the targets and organs-at-risk (OAR) were analyzed in all 28 orbits compared between the different techniques. RESULTS: CI generated by VMAT was superior to that produced by 3DCRT(p < .001) and LOF (p < .001). As expected, 3DCRT was also superior to LOF (p = .007). Regarding the OARs sparing dose (lens, globes, retina and lacrimal glands), VMAT showed a significant benefit when compared with 3DCRT and LOCF, with no differences between the two latter techniques. CONCLUSIONS: VMAT should be preferred over 3DCRT and LOF for bilateral Graves' ophthalmopathy treatment.
Authors: Min Rao; Wensha Yang; Fan Chen; Ke Sheng; Jinsong Ye; Vivek Mehta; David Shepard; Daliang Cao Journal: Med Phys Date: 2010-03 Impact factor: 4.071
Authors: Cejana Casimiro de Deus Cardoso; Adelmo José Giordani; Angela Maria Borri Wolosker; Luis Souhami; Paulo Gois Manso; Rodrigo Souza Dias; Helena Regina Comodo Segreto; Roberto Araujo Segreto Journal: Int J Radiat Oncol Biol Phys Date: 2011-05-06 Impact factor: 7.038
Authors: Kham Nguyen; David Cummings; Vincent C Lanza; Kathleen Morris; Congjun Wang; Jordan Sutton; John Garcia Journal: Med Dosim Date: 2013-04-08 Impact factor: 1.482
Authors: Andrea Holt; Dirk Van Gestel; Mark P Arends; Erik W Korevaar; Danny Schuring; Martina C Kunze-Busch; Rob Jw Louwe; Corine van Vliet-Vroegindeweij Journal: Radiat Oncol Date: 2013-01-31 Impact factor: 3.481