Hipertiroidili Hastalarda Ampirik Sabit Doz Radyoaktif İyot Uygulamasının Tedavi Başarısı Üzerine Etkisi ve Literatürdeki Hassas Dozimetrik Yöntemlerle Kıyaslanması

Çalışmamızda kliniğimizde hipertiroidi nedeniyle ampirik sabit doz ile uyguladığımız radyoaktif iyot tedavisinin (RIT) başarısının, diğer bir yöntem olan hassas dozimetrik doz hesaplama ile uygulanan RIT’ın literatürdeki başarısı ile karşılaştırmayı amaçladık. Hipertiroidi nedeniyle kliniğimizde RIT uygulanan 206 hastanın dosyasını incelendik. Cinsiyet, yaş gibi demografik özellikler ile tiroid sintigrafisi, tiroid fonksiyon testlerini (TSH ve sT4) değerlendirdik. RIT sonrası en az altı aylık takipleri yapıldı. RIT sonrası 177 hastada (%85.9) ilk altı ayda ötiroidi veya hipotiroidi izlendi ve tedavi başarılı kabul edildi. Otuz sekiz hastada ise (%14.1) ilk altı ayda ötiroidi veya hipotiroidi izlenmedi ve bu hastalarda RIT başarısız kabul edildi. Cinsiyet ve yaş ile tedavi başarısı arasında istatistiksel anlamlı ilişki bulunmadı. Toksik multinoduler guatr izlenen gruptaki başarı oranı diffüz hiperaktif tiroid bezi ve toksik adenomlu diğer iki gruptan daha düşüktü. Tedavi öncesindeki TSH değeri yüksek olanlarda tedavi başarısı daha yüksek idi. Hipertiroidili hastalarda ampirik sabit dozda uygulanan RIT başarılı bir yöntem olduğu ve literatürdeki hassas dozimetrik yöntemle hesaplanan doz ile uygulanan RIT ile benzer başarı oranına sahip olduğu sonucuna vardık. Bu nedenle sabit doz uygulaması daha fazla hasta rahatlığı, zaman tasarrufu sağlamak, aynı zamanda tıbbi maliyetleri düşürmek için uygun ve başarılı bir yöntem olarak kullanılabilir.

Anahtar Kelimeler:

Tiroid sintigrafisi, Radyoaktif iyot tedavisi, Hipertiroidizm, Hyperthyroidism, Radioactive Iodine Therapy, Thyroid Scintigraphy

The Effect of Empirical Fixed-Dose Radioactive Iodine Administration on Treatment Success in Patients with Hyperthyroidism and its Comparison with Sensitive Dosimetric Methods in the Literature

Our study aimed to evaluate the effect of empirical fixed-dose iodine administration on treatment success in patients admitted to our clinic with hyperthyroidism and compare it with sensitive dosimetric methods in the literature. The files of 206 patients who received radioactive iodine therapy (RIT) in our clinic between 2014-2020 were retrospectively analyzed. Patients’ demographic characteristics such as gender, age, pre-treatment thyroid scintigraphy, pre-, and post-treatment thyroid function tests (TSH and fT4) were evaluated. The patients were followed up for six months after radioactive iodine treatment. After RIT, euthyroidism or hypothyroidism was observed in 177 patients (85.9%) in the first six months and was accepted as a complete cure. In 38 patients (14.1%), euthyroid or hypothyroidism was not observed in the first six months, and RIT treatment was considered unsuccessful. There was no statistically significant relationship between treatment response with gender and age. The success rate in the group with toxic multinodular goiter was statistically significantly lower than the other two groups with the diffuse hyperactive thyroid gland and a single hyperactive nodule. The treatment success rate was statistically higher in the patients with high pre-treatment TSH values. We concluded that empirical fixed-dose radioactive iodine therapy is a very successful method in the patients with hyperthyroidism and has a similar success rate with RIT doses calculated by the precise dosimetric method in the literature. For this reason, the fixed-dose application can be used as a convenient and successful method to provide more patient comfort, time savings and reduce medical costs.

Keywords:

Hyperthyroidism, Radioactive Iodine Therapy, Thyroid Scintigraphy,

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