Maxon H R, Englaro E E, Thomas S R, Hertzberg V S, Hinnefeld J D, Chen L S, Smith H, Cummings D, Aden M D
Department of Radiology, Eugene L. Saenger Radioisotope Laboratory, University of Cincinnati Medical Center, Ohio 45267-0577.
J Nucl Med. 1992 Jun;33(6):1132-6.
For almost five decades, 131I treatment of thyroid cancer has been based empirically on administered activity rather than on actual radiation doses delivered. In 1983, we defined radiation dose thresholds for successful treatment. This report is concerned with the subsequent validation of those thresholds in 85 patients. The successful ablation of thyroid remnants occurred after a single initial 131I administration in 84% of inpatients and in 79% of outpatients when treatment was standardized to a radiation dose of at least 30,000 cGy (rad). Administered activities low enough to permit outpatient therapy could be used in 47% of the patients. Lymph node metastases were treated successfully in 74% of patients with a single administration of 131I calculated to deliver at least 8,500 cGy (rad). For athyrotic patients with nodal metastases only, success was achieved in 86% of patients at tumor doses of at least 14,000 cGy (rad). These success rates are equal to or better than those reported with empiric methods of 131I administration. The individualized treatment planning selectively allocates hospitalization and higher exposures to 131I to those patients who require them.
近五十年来，131I治疗甲状腺癌一直是凭经验依据给药活度，而非所给予的实际辐射剂量。1983年，我们确定了成功治疗的辐射剂量阈值。本报告关注随后对85例患者的这些阈值的验证情况。当治疗标准化为至少30,000厘戈瑞（拉德）的辐射剂量时，84%的住院患者和79%的门诊患者在单次初始给予131I后甲状腺残余组织成功消融。47%的患者可以使用低到足以允许门诊治疗的给药活度。74%单次给予计算能提供至少8,500厘戈瑞（拉德）131I的患者的淋巴结转移得到成功治疗。对于仅伴有淋巴结转移的无甲状腺患者，在肿瘤剂量至少为14,000厘戈瑞（拉德）时，86%的患者获得成功。这些成功率等于或优于用经验性131I给药方法报告的成功率。个体化治疗计划有选择地将住院治疗和更高的131I暴露分配给那些需要的患者。
