Radioiodine therapy for multinodular toxic goiter

被引:69
作者
Nygaard, B
Hegedüs, L
Ulriksen, P
Nielsen, KG
Hansen, JM
机构
[1] Univ Copenhagen, Herlev Hosp, Dept Endocrinol F112, DK-2730 Herlev, Denmark
[2] Univ Copenhagen, Herlev Hosp, Dept Ultrasound, DK-2730 Herlev, Denmark
[3] Odense Univ Hosp, Dept Endocrinol, DK-5000 Odense, Denmark
关键词
D O I
10.1001/archinte.159.12.1364
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Radiolabeled iodine 131 therapy is used for treatment of multinodular toxic goiter, but longterm follow-up studies are lacking. Methods: A-prospective study of 130 consecutive patients (115 women) treated with I-131 for multinodular toxic goiter and followed by evaluation of thyroid volume (determined using ultrasound). and thyroid function variables. Results: The patients were observed for a median of 72 months (range, 12-180 months). Sixty-six patients received antithyroid drug pretreatment; 64 did not. Iodine 131 treatment (3.7 MBq/g thyroid tissue corrected to a 100% 24-hour I-131 uptake) was given as a single dose in 81 patients, 2 doses in 38, and to 5 doses in 11. One or 2 treatments cured 119 patients (92%), and 68 (52%) became euthyroid within 3 months after 1 I-131 treatment. The median I-131 dose was 370 MBq (range, 93-1850 MBq). Forty-nine patients needing more than 1 I-131 dose had a reduction in median thyroid volume from 56 mL (range, 21-430 mL) to 44 mL (range, 15-108 mL), representing a 24% reduction related to the insufficient I-131 dose. In all patients, the initial median thyroid volume of 44 mt (range, 16-430 mL) decreased to 25 mL (range, 8-120 mL) (P<.005), representing a median reduction of 43%, 24 months after the last I-131 dose. Hypothyroidism evaluated using life-table analysis developed in 6% of patients who did not receive antithyroid pretreatment and 20% who did (P<.005) after a,median of 42 months (range, 3-60 months), the total hypothyroidism frequency being 14% within 5 years of treatment. Conclusions: Ninety-two percent of patients with multinodular toxic goiter were cured with 1 or 2 treatments. The thyroid volume tvas reduced by 43%, with few side effects. Iodine 131 should be the choice of treatment inpatients with multinodular toxic goiter.
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页码:1364 / 1368
页数:5
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