三维适形放射治疗Graves眼病38例近期临床观察

目的分析三维适形放射治疗Graves眼病的近期临床疗效。方法2004—2008年，对38例Graves眼病患者行球后三维适形放射治疗，180cGy／次，1次／d，5次／周，肿瘤总剂量1980～2340eGy，中位剂量为2160eGy。结果照射后分别有36．8％、50％的患者病情明显改善或部分改善，10．5％的或者病情稳定，2．7％的患者病情进展，总有效率86．8％，有软组织及角膜受累的病例放射治疗后症状改善最为明显（P〈0．05）。结论。三维适形放射治疗可有效控制Graves眼病病情的进展，突眼症状明显改善，疗效较好，副反应小。

Clinical analysis of Gravers orbitopathy on Three - Dimensional conformal radiotherapy in 38 cases

Objective To evaluate the response of Graves orbitopathy to Three - Dimensional conformal radiotherapy. Methods Form 2004 to 2008, 38 patients received bilateral orbital Three - Dimensional conformal radiotherapy, 180 cGy/Time,5t/week,Dt： 1980 -2340 cGy,M：2160 cGy. Results 36.8% patients had a good excellent response,50% had a partial response, 10.5% patients were stable,2.7%, patients had a progression of disease. The signs that the best responded to radiotherapy were the infihation of soft tissues and the corneal involvement. Responses of proptosis or oculomotor disorders were more complete when these signs were not advanced at the time of treatment. The best results were recorded tot early or moderately advanced presentation （ P 〈 0.05 ）. Conclusion Three - Dimensional orbital conformal irradiation was efficient in Graves orbitopathy by stopping the progression of disease in almost all case： It can improve the exophthahnic symptomsobtain objective responses and avoid surgical treatments particularly when signs were moderate.