Salvatori M, Rufini V, Garganese M C, Di Giuda D
Istituto di Medicina Nucleare, Università Cattolica del S. Cuore, Policlinico A. Gemelli, Roma.
Rays. 2000 Apr-Jun;25(2):221-38.
Radioiodine therapy has been successfully applied for over 50 years in the management of differentiated thyroid carcinoma. Careful patient preparation and selection of the optimal dose of radioiodine to be administered are two factors of major importance in the course of management. Main indications for 131I therapy are the ablation of residual thyroid tissue after thyroidectomy, the treatment of locoregional recurrence and distant metastases which involve almost exclusively the lung and bones. A controversial aspect is that of patients with high serum TG levels but negative whole body 131I scintigraphy for whom there is no general agreement. Other controversial aspects involve ablation therapy as the selection of patients to be treated and the control of its efficacy. The cost and possible adverse side-effects of 131I therapy require a careful analysis of prognostic factors in each patient candidate for the treatment.
放射性碘治疗已成功应用于分化型甲状腺癌的治疗五十多年。在治疗过程中，仔细的患者准备以及选择最佳的放射性碘给药剂量是两个至关重要的因素。131I治疗的主要适应证是甲状腺切除术后残余甲状腺组织的消融、局部区域复发和远处转移的治疗，远处转移几乎仅累及肺和骨。一个有争议的方面是血清TG水平高但全身131I闪烁显像阴性的患者，对此尚无普遍共识。其他有争议的方面包括作为治疗患者选择的消融治疗及其疗效的控制。131I治疗的成本和可能的不良副作用需要对每个治疗候选患者的预后因素进行仔细分析。
