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Feasibility of tomotherapy for Graves’ ophthalmopathy

Dosimetry comparison with conventional radiotherapy

Wirksamkeit der Tomotherapie von Ophthalmopathie bei Morbus Basedow

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Abstract

Purpose

To compare the dosimetry of tomotherapy and the conventional half-beam technique (HBT) or non-split beam technique (NSBT) for target coverage and radiation dose to the lacrimal glands and lens.

Patients and Methods

A retrospective review of 7 patients with Graves’ ophthalmopathy who had radiotherapy because of disease progression on high steroid dose is reported: 3 patients were treated with tomotherapy and 4 patients with HBT.

Results

Compared to HBT, tomotherapy may provide better target coverage and significant reduction of radiation dose to the lacrimal glands and a higher dose to the lens. The NSBT improved target coverage but resulted in significantly higher doses to the lens and lacrimal glands.

Conclusion

Tomotherapy may provide better coverage of the target volume and may be more effective in reducing severe exophthalmos compared to the conventional radiotherapy technique.

Zusammenfassung

Ziel

Vergleich zwischen Dosimetrie der Tomotherapie und der konventionellen Half-beam-Technik (HBT) oder Non-split-beam-Technik (NSBT) für die Erfassung des Zielvolumens und der Strahlendosis an Tränendrüsen und Linse.

Patienten und Methoden

Eine retrospektive Analyse von 7 Patienten mit Graves’ Ophthalmopathie, die wegen Progression der Erkrankung zur Notwendigkeit hochdosierter Steroidgabe eine Strahlentherapie erhielten. 3 Patienten wurden mit Tomotherapie und 4 Patienten mit HBT behandelt.

Ergebnisse

Im Vergleich zu HBT konnte die Tomotherapie bessere Erfassung des Zielvolumens und signifikante Reduktion der Strahlendosis an den Tranendrüsen sowie eine höhere Strahlendosis an der Linse erreichen. NSBT verbesserte die Erfassung des Zielvolumens, resultierte aber in signifikant höherer Strahlendosis an Linse und Tränendrüsen.

Schlussfolgerung

Tomotherapie kann – verglichen mit konventioneller Strahlentherapietechnik – zu besserer Erfassung des Zielvolumens und wirksamerer Verminderung des schweren Exophthalmus führen.

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Authors and Affiliations

  1. Department of Radiation Oncology, University of Arizona, Tucson, AZ, USA

    Nam P. Nguyen MD, Shane P. Krafft, Misty Ceizyk, Siyoung Jang, Anand Desai, Dave Abraham, Lars Ewell, Christopher Watchman, Russ Hamilton, Beng-Hoey Jo & Lexie Smith-Raymond

  2. Department of Biostatistics, East Carolina University, Greenville, NC, USA

    Paul Vos

  3. Department of Radiation Oncology, University Hospitals of Geneva, Geneva, Switzerland

    Vincent Vinh-Hung

  4. Department of Radiation Oncology, Marshfield Clinic, Marshfield, WI, USA

    Ulf Karlsson

  5. Associate Professor of Radiation Oncology, University of Arizona, 1501 N. Campbell Ave, Tucson, AZ, 85724-5081, USA

    Nam P. Nguyen MD

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  1. Nam P. Nguyen MD
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Correspondence to Nam P. Nguyen MD.

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Nguyen, N.P., Krafft, S.P., Vos, P. et al. Feasibility of tomotherapy for Graves’ ophthalmopathy. Strahlenther Onkol 187, 568–574 (2011). https://doi.org/10.1007/s00066-011-2220-z

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  • DOI: https://doi.org/10.1007/s00066-011-2220-z

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