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  • Title: Radiotherapy for Graves' orbitopathy: results of a national survey.
    Author: Heyd R, Seegenschmiedt MH, Strassmann G, Micke O, Makoski HB, Zamboglou N, German Cooperative Group on Radiotherapy for Benign Diseases (GCG-BD).
    Journal: Strahlenther Onkol; 2003 Jun; 179(6):372-6. PubMed ID: 12789462.
    Abstract:
    BACKGROUND: Graves' orbitopathy (GO) is a widely accepted indication for radiation therapy (RT). In conjunction with the German Cooperative Group on Radiotherapy for Benign Diseases (GCG-BD), a national survey was conducted in order to assess whether or not there is a consensus on the indication for RT and various treatment factors which were studied. MATERIAL AND METHODS: A questionnaire was circulated to 190 RT institutions to obtain relevant data concerning the patients' workload, stage-dependent indication, and diagnostic procedures, which were considered to be necessary. Further questions addressed details on radiation technique and dose-fractionation schedules, the combined use of corticoids, and salvage RT after previous treatment failure following RT. RESULTS: With a response rate of 152/190 (80%), the survey is nationally representative. Based on the case workload, an estimated annual number of 1,600 GO cases are treated in German radiotherapy departments. With an 88% consensus, stages II-V are the typical indications. 85% considered imaging studies necessary for indication and only 48% for laboratory tests. 76% of the institutions used total doses in the range of 15-20 Gy, and conventional fractionation was most common (57%). 82% used a face mask fixation and 67% CT-based treatment planning. Approximately 50% would prescribe salvage RT, and total doses in the range of 20-40 Gy were considered to be acceptable. CONCLUSIONS: The survey revealed a consensus concerning most of the factors studied. We recommend to review the patterns of care for RT of other entities of benign diseases and to implement a quality assurance program both on national and international levels.
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