Long-Term Results of Fixed High-Dose I-131 Treatment for Toxic Nodular Goiter: Higher Euthyroidism Rates in Geriatric Patients

Amaç: Geriatrik hasta grubu kendine has özellikleri, acil ve zorlu durumları olan bir popülasyondur. Toksik nodüler guatr (TNG) sıklığı yaşla beraber artmaktadır, bununla birlikte ülkemiz gibi düşük iyot alımı bölgelerindeki sıklığı normal sıklığının daha da üzerindedir. Altmış beş yaş üzerinde ülkemizde bu oran %37,5 olarak bildirilmektedir. Bu geriye dönük çalışmada, yüksek sabit doz radyoaktif iyot (RAİ) uygulamasının sonuçlarını bütünüyle değerlendirmek ve özellikle geriatrik hasta grubunun sonuçlarında bir farklılık olup olmadığını araştırmak amaçlanmıştır. Yöntem: TNG nedeniyle, yüksek doz I-131 (370-740 MBq) tedavisi almış 103 hastanın takip dosyaları incelendi. Yaş, cinsiyet, sintigrafik bulgular, tedavi öncesi ve sonrası takip tiroid fonksiyon testleri, antitiroid ilaç tedavisinin süresi, ötiroidi veya hipotiroidi durumunun gelişimi değerlendirildi. Geriatrik hasta grubunun olası farklı sonuçlarını daha detaylı değerlendirmek amacıyla; 65 yaş ve üzeri hasta popülasyonu ayrıca ele alınarak, 65 yaş altı grubunun sonuçları ile karşılaştırıldı.Bulgular: Tek doz RAİ uygulaması sonucunda tedavi etkinliği %90 olarak bulundu. Hipertiroidi ortalama 7±7, 2 ayda tedavi edildi. Bir yılın sonunda, ötiroidi oranı %70, hipotiroidi oranı ise %30 olarak hesaplandı. İncelenen faktörler arasında yalnızca yaşın tedavi sonuçlarına anlamlı etkisi belirlendi. Geriatrik hasta grubunda daha yüksek oranda ötiroidi sağlandı. Sonuç: Sistemik hastalıkların sıklığı nedeniyle hızlı tedavi gerektiren geriatrik hasta grubunda, sabit yüksek doz I-131 uygulaması öncelikle tercih edilmesi gereken yöntemdir. Sabit yüksek doz RAİ ile TNG tedavisi, başarı oranı yüksek, hızlı ve etkin bir tedavidir ve geriatrik hasta gurubunda daha yüksek ötiroidi oranları elde edilebilir.

Toksik Nodüler Guatrda Yüksek Sabit Doz I-131 Tedavisinin Uzun Dönem Sonuçları: Geriatrik Popülasyonda Daha Yüksek Ötiroidi Oranı

Objective: Geriatric patient population has special importance due to particular challenges. In addition to the increase in incidence of toxic nodular goiter (TNG) with age, it has a high incidence in the regions of low-medium iodine intake such as in our country. The aim of this study was to evaluate the overall outcome of high fixed dose radioiodine (RAI) therapy, and investigate the particular differences in the geriatric patient population. Methods: One hundred and three TNG patients treated with high dose I-131 (370-740 MBq) were retrospectively reviewed. The baseline characteristics; age, gender, scintigraphic patterns and thyroid function tests before and after treatment, as well as follow-up, duration of antithyroid drug (ATD) medication and achievement of euthyroid or hypothyroid state were evaluated. The patient population was divided into two groups as those=>65 years and those who were younger, in order to assess the effect of age. Results: Treatment success was 90% with single dose RAI therapy. Hyperthyroidism was treated in 7±7, 2 months after RAI administration. At the end of the first year, overall hypothyroidism rate was 30% and euthyroid state was achieved in 70% of patients. Age was found to be the only statistically significant variable effecting outcome. A higher ratio of euthyroidism was achieved in the geriatric patient population. Conclusion: High fixed dose I-131 treatment should be preferred in geriatric TNG patients in order to treat persistent hyperthyroidism rapidly. The result of this study suggests that high fixed dose RAI therapy is a successful modality in treating TNG, and high rates of euthyroidism can be achieved in geriatric patients.

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Kaynak Göster

Molecular Imaging and Radionuclide Therapy
  • ISSN: 2146-1414
  • Yayın Aralığı: Yılda 3 Sayı
  • Başlangıç: 1992

1.1b341

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