Kobe C, Weber I, Eschner W, Sudbrock F, Schmidt M, Dietlein M, Schicha H
Department of Nuclear Medicine, University of Cologne, Kerpener Strasse 62, Cologne, Germany.
Nuklearmedizin. 2008;47(4):153-6.
This study was performed to analyse the impact of the choice of antithyroid drugs (ATD) on the outcome of ablative radioiodine therapy (RIT) in patients with Graves' disease.
PATIENTS, MATERIAL, METHODS: A total of 571 consecutive patients were observed for 12 months after RIT between July 2001 and June 2004. Inclusion criteria were the confirmed diagnosis of Graves' disease, compensation of hyperthyroidism and withdrawal of ATD two days before preliminary radioiodine-testing and RIT. The intended dose of 250 Gy was calculated from the results of the radioiodine test and the therapeutically achieved dose was measured by serial uptake measurements. The end-point measure was thyroid function 12 months after RIT; success was defined as elimination of hyperthyroidism. The pretreatment ATD was retrospectively correlated with the results achieved.
Relief from hyperthyroidism was achieved in 96% of patients. 472 patients were treated with carbimazole or methimazole (CMI) and 61 with propylthiouracil (PTU). 38 patients had no thyrostatic drugs (ND) prior to RIT. The success rate was equal in all groups (CMI 451/472; PTU 61/61; ND 37/38; p = 0.22).
Thyrostatic treatment with PTU achieves excellent results in ablative RIT, using an accurate dosimetric approach with an achieved post-therapeutic dose of more than 200 Gy.
本研究旨在分析抗甲状腺药物（ATD）的选择对格雷夫斯病患者放射性碘消融治疗（RIT）效果的影响。
患者、材料与方法：2001年7月至2004年6月期间，对571例连续接受RIT治疗的患者进行了为期12个月的观察。纳入标准为确诊格雷夫斯病、甲亢得到控制以及在初步放射性碘检测和RIT前两天停用ATD。根据放射性碘检测结果计算预期剂量250 Gy，并通过连续摄取测量来测定治疗实际达到的剂量。终点指标为RIT后12个月的甲状腺功能；成功定义为甲亢消除。对治疗前使用的ATD与所取得的结果进行回顾性关联分析。
96%的患者甲亢症状得到缓解。472例患者接受了卡比马唑或甲巯咪唑（CMI）治疗，61例接受丙硫氧嘧啶（PTU）治疗。38例患者在RIT前未使用抗甲状腺药物（ND）。所有组的成功率相同（CMI组451/472；PTU组61/61；ND组37/38；p = 0.22）。
使用精确的剂量测定方法，治疗后剂量达到200 Gy以上，PTU进行的抗甲状腺治疗在放射性碘消融治疗中取得了优异的效果。
