Department of Nuclear Medicine, University of Würzburg, Oberdürrbacher Strasse 6, D-97080 Würzburg, Germany.
Endocr Relat Cancer. 2010 Jun 3;17(3):R161-72. doi: 10.1677/ERC-10-0071. Print 2010 Sep.
Adjuvant therapy of differentiated thyroid cancer with radioactive iodine ((131)I) is a standard procedure for the ablation of remnant thyroid tissue following surgery and for the treatment of iodine-avid metastases. Presently, there are two dosimetric concepts for the treatment of thyroid cancer using radioiodine: a) the bone marrow dose limited approach and b) lesion-based dosimetry. Both concepts and their clinical applications are described. In addition, the use of (124)I as a diagnostic and dosimetric agent is discussed. Treatment of children and adolescents with radioiodine requires special precautions; individualized approaches in this setting are reviewed. The limitations of treatments aiming at high absorbed doses are addressed as well as the doses to normal organs. Finally, new concepts for further elaborating the potential of thyroid cancer treatment using (131)I are introduced.
分化型甲状腺癌的放射性碘 ((131)I) 辅助治疗是手术切除残余甲状腺组织和治疗碘摄取转移灶的标准方法。目前,使用放射性碘治疗甲状腺癌有两种剂量学概念:a) 骨髓剂量限制方法和 b) 基于病变的剂量学。本文描述了这两种概念及其临床应用。此外,还讨论了 (124)I 作为诊断和剂量学试剂的应用。儿童和青少年的放射性碘治疗需要特殊的预防措施;本文回顾了这种情况下的个体化方法。还讨论了旨在提高吸收剂量的治疗方法的局限性以及对正常器官的剂量。最后,引入了使用 (131)I 进一步阐述甲状腺癌治疗潜力的新概念。