Radioterapia para pacientes portadores de oftalmopatia de Graves: avaliação clínica e radiológica

• Ano de defesa: 2009
• Autor(a) principal: Cardoso, Cejana Casimiro de Deus [UNIFESP]
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Corticoterapia; Radioterapia; Ressonância magnética; Oftalmopatia de Graves
• Link de acesso: http://repositorio.unifesp.br/handle/11600/10006

Purpose: To evaluate the clinical and radiological response of patients with Graves’ ophthalmopathy underwent to orbital radiotherapy concomitant or not with corticotherapy. Methods and materials: Eighteen patients (36 orbits) were underwent to orbital radiotherapy with a total dose of 10 Gy, fractioned in 1 Gy once a week over 10 weeks; nine of these patients made concomitant use of corticoids. The patients were evaluated clinically by means of a verbal questionnaire and by the evaluation of the clinical activity score (CAS), and radiologically, by magnetic resonance (MR) imaging parameters, before treatment and six months following it. Results: After treatment, total improvement of ocular pain, palpebral edema, visual acuity and ocular motility was observed. The patients presented a significant decrease in the symptoms such as tearing, diplopia, conjunctival hyperemia and ocular grittiness. There was a significant reduction of the inflammatory activity in the left eye, and all patients were classified as quiescent in the right eye. The MR indicated a marked decrease in ocular muscle thickness and in signal intensity bilaterally. The comparative analysis between groups I (radiotherapy exclusively) and II (radiotherapy combined with corticotherapy) showed no statistical difference regarding the clinical and radiological parameters evaluated. Conclusion: Whether associated or not with corticotherapy, radiotherapy delivered in low dose and in a protracted scheme suggest to be effective and safe, as verified by the clinical and radiological improvements, and is an efficient therapeutic option for patients with Graves’ ophthalmopathy.