Yıl: 2018 Cilt: 27 Sayı: 1 Sayfa Aralığı: 1 - 7 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Tiroid Oftalmopatisinde Retroorbital Radyoterapi Sonuçlarımız

Öz:
T Amaç: Tiroid oftalmopatisi nedeni ile retroorbital radyoterapi (RT) uygulanan hastaların klinik özelliklerini ve tedavi sonuçlarını değerlendirmektir. Gereç ve Yöntemler: Ocak 1998--Şubat 2014 tarih-- leri arasında tiroid oftalmopatisi nedeni ile RT uygulanan 19 hastanın verileri geriye dönük olarak ince-- lendi. Dokuz ay ve üzeri izlem altında olan 15 hasta çalışmaya alındı. Radyoterapi, retroorbital bölgeye, 10 fraksiyonda toplam 20 Gray, bireysel orfit baş maskesi kullanılarak uygulandı. Hastalar, RT uygulan-- ması öncesi ile tedavi sonrasındaki izlemlerde klinik aktivite skoru, Hertel ölçümleri, göz hareketleri, dip-- lopi varlığı, immünsüpresif ilaç ve ilave tedavi gereksinimleri açısından değerlendirildi. İstatistiksel analiz için Wilcoxon bağımlı değer analizi kullanıldı. Bulgular: Hastaların 8'i kadın, 7'si erkek idi. Ortalama yaş 49,61125 (30--72) yıl, ortalama izlem süresi 26,5:132 (9--168) ay olarak saptandı. Radyoterapi, 14 hastada her iki retroorbital bölgeye, bir hastada ise tek taraflı olmak üzere toplamda 29 göze uygulandı. Tedavi üç hastada konvansiyonel, diğer hastalarda üç boyutlu konformal teknikle uygulandı. Sekiz hastaya RT ön-- cesi, yedi hastaya ise RT ile eş zamanlı steroid tedavisi verilmişti. Radyoterapi öncesi klinik aktivite skoru ortalama 4,6ı1,3 (3--7) iken, RT sonrası 3,6 ve 9. aylarda sırasıyla 2,711,1, 1,2:1,3 ve 0,2:0,4 saptandı (her biri için p<0,05). Tedavi öncesi Hertel ölçüm değerleri ortalama 23,4 mm iken, tedavi sonrası 9. ayda 21,7 mm saptandı (p>0,05). Dört hastaya tarsorafi, kas geriletme cerrahisi, kas ve üst kapağa botoks enjeksiyonu şeklinde ilave cerrahi uygulamalar tekli ve/veya kombine olarak yapıldı. Hiçbir hastada RT'ye bağlı de-- rece 3--4 yan etki saptanmadı. Sonuç: Tiroid oftalmopatisinin aktif döneminde retroorbital RT güvenli ve etkili bir tedavi seçeneği olup ciddi yan etki oluşturmadan hastaların klinik aktivite skorlarında belirgin düzelme sağlamaktadır.
Anahtar Kelime:

Konular: Tıbbi Araştırmalar Deneysel Hematoloji Onkoloji Pediatri Ortopedi

Treatment Results of Retro—orbital Radiotheraphy in Patients with Thyroid Ophthalmopathy

Öz:
OObbjjeeccttiivvee:: To evaluate the clinical features and treatment results in patiens with thyroid oph- thalmopathy treated with retroorbital radiotheraphy. MMaatteerriiaall aanndd MMeetthhooddss:: Medical records of 19 patients who were treated with orbital radiotherapy because of thyroid-associated ophthalmopathy between Jan- uary 1998-February 2014 were reviewed retrospectively. Fifteen patients who were followed-up 9 months and more after the treatment were enrolled the study. Radiotherapy was delivered with personal orfit head mask to the retro-orbital field in 10 fractions with the total dose of 20 Gray. Clinical activity score, Hertel measurements, eye movements, diplopia, need for immunsupressive treatment and additional sur- gery were evaluated. Wilcoxon dependent value analyses was used for statistical evaluation. RReessuullttss:: Eight patients were female and seven were male. Mean age of the subjects was 49.6±12.5 years (30-72 years). Mean follow-up period was 26.5±13.2 months (9-168 months). Radiotherapy was delivered to the bilat- eral retro-orbital field in 14 patients and unilaterally in one patient. Three patients were treated with the conventional radiotherapy technics and the others with conformal technics. Eight patients had steroid medication before radiotherapy and 7 patients had concurrently. While the mean clinical activity score was 4.6±1.3 before radiotherapy, it was 2.7±1.1, 1.2±1.3 and 0.2±0.4 in 3th, 6thand 9thmonths after retro-orbital RT application, respectively (p˂0.05 for each). The mean Hertel measurement value was 23.4 mm before treatment and 21.7 mm in 9thmonth after RT treatment (p ˃0.05). Four patients had further mono and/or combined surgical requirement such as tarsoraphy, muscle ressession surgery, botox injec- tion to the upper eyelid and muscle. None of the patients had grade 3-4 side effects associated with ra- diotherapy. CCoonncclluussiioonn:: Orbital radiotheraphy is a safe and effective treatment option in the active period of the thyroid ophthalmopathy and provides remarkable improvement in clinical activity scores without any severe side effect
Anahtar Kelime:

Konular: Tıbbi Araştırmalar Deneysel Hematoloji Onkoloji Pediatri Ortopedi
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA BAJİNA M, ayhan z, AKTÜRK N, ÖZDEMİR O, Yaman A, AKMAN F, AYDIN B (2018). Tiroid Oftalmopatisinde Retroorbital Radyoterapi Sonuçlarımız. , 1 - 7.
Chicago BAJİNA Meltem SÖYLEV,ayhan ziya,AKTÜRK NESRIN,ÖZDEMİR Okan,Yaman Aylin,AKMAN Fadime,AYDIN Barbaros Tiroid Oftalmopatisinde Retroorbital Radyoterapi Sonuçlarımız. (2018): 1 - 7.
MLA BAJİNA Meltem SÖYLEV,ayhan ziya,AKTÜRK NESRIN,ÖZDEMİR Okan,Yaman Aylin,AKMAN Fadime,AYDIN Barbaros Tiroid Oftalmopatisinde Retroorbital Radyoterapi Sonuçlarımız. , 2018, ss.1 - 7.
AMA BAJİNA M,ayhan z,AKTÜRK N,ÖZDEMİR O,Yaman A,AKMAN F,AYDIN B Tiroid Oftalmopatisinde Retroorbital Radyoterapi Sonuçlarımız. . 2018; 1 - 7.
Vancouver BAJİNA M,ayhan z,AKTÜRK N,ÖZDEMİR O,Yaman A,AKMAN F,AYDIN B Tiroid Oftalmopatisinde Retroorbital Radyoterapi Sonuçlarımız. . 2018; 1 - 7.
IEEE BAJİNA M,ayhan z,AKTÜRK N,ÖZDEMİR O,Yaman A,AKMAN F,AYDIN B "Tiroid Oftalmopatisinde Retroorbital Radyoterapi Sonuçlarımız." , ss.1 - 7, 2018.
ISNAD BAJİNA, Meltem SÖYLEV vd. "Tiroid Oftalmopatisinde Retroorbital Radyoterapi Sonuçlarımız". (2018), 1-7.
APA BAJİNA M, ayhan z, AKTÜRK N, ÖZDEMİR O, Yaman A, AKMAN F, AYDIN B (2018). Tiroid Oftalmopatisinde Retroorbital Radyoterapi Sonuçlarımız. Türkiye Klinikleri Oftalmoloji Dergisi, 27(1), 1 - 7.
Chicago BAJİNA Meltem SÖYLEV,ayhan ziya,AKTÜRK NESRIN,ÖZDEMİR Okan,Yaman Aylin,AKMAN Fadime,AYDIN Barbaros Tiroid Oftalmopatisinde Retroorbital Radyoterapi Sonuçlarımız. Türkiye Klinikleri Oftalmoloji Dergisi 27, no.1 (2018): 1 - 7.
MLA BAJİNA Meltem SÖYLEV,ayhan ziya,AKTÜRK NESRIN,ÖZDEMİR Okan,Yaman Aylin,AKMAN Fadime,AYDIN Barbaros Tiroid Oftalmopatisinde Retroorbital Radyoterapi Sonuçlarımız. Türkiye Klinikleri Oftalmoloji Dergisi, vol.27, no.1, 2018, ss.1 - 7.
AMA BAJİNA M,ayhan z,AKTÜRK N,ÖZDEMİR O,Yaman A,AKMAN F,AYDIN B Tiroid Oftalmopatisinde Retroorbital Radyoterapi Sonuçlarımız. Türkiye Klinikleri Oftalmoloji Dergisi. 2018; 27(1): 1 - 7.
Vancouver BAJİNA M,ayhan z,AKTÜRK N,ÖZDEMİR O,Yaman A,AKMAN F,AYDIN B Tiroid Oftalmopatisinde Retroorbital Radyoterapi Sonuçlarımız. Türkiye Klinikleri Oftalmoloji Dergisi. 2018; 27(1): 1 - 7.
IEEE BAJİNA M,ayhan z,AKTÜRK N,ÖZDEMİR O,Yaman A,AKMAN F,AYDIN B "Tiroid Oftalmopatisinde Retroorbital Radyoterapi Sonuçlarımız." Türkiye Klinikleri Oftalmoloji Dergisi, 27, ss.1 - 7, 2018.
ISNAD BAJİNA, Meltem SÖYLEV vd. "Tiroid Oftalmopatisinde Retroorbital Radyoterapi Sonuçlarımız". Türkiye Klinikleri Oftalmoloji Dergisi 27/1 (2018), 1-7.