Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts 02118, USA.
Curr Opin Endocrinol Diabetes Obes. 2012 Oct;19(5):420-8. doi: 10.1097/MED.0b013e328357fa0c.
Review of the management decisions that must be made by the endocrinologist during the use of radioactive iodine (RAI) therapy of hyperthyroidism and differentiated thyroid cancer.
Since the 1940s radioactive (131)I (RAI) therapy has been a major component of the treatment of hyperthyroidism and differentiated thyroid cancer. RAI is the most common definitive treatment of hyperthyroidism. Pretherapy decisions including use of antithyroid medication and low-iodine diet will be discussed with the relevant supportive literature. The method of semi-quantitative calculation used for RAI treatment of hyperthyroidism will be described. Evidence-based guideline for the management of differentiated thyroid cancer by the American Thyroid Association, new drug development and recent randomized controlled trials have changed current practice of how RAI is used for remnant ablation and adjuvant therapy of differentiated thyroid cancer.
RAI is a common tool for the endocrinologist in the management of hyperthyroidism and differentiated thyroid cancer. Review of the management decisions and practice of RAI therapy will educate the endocrinologist of the literature supporting current RAI use in hyperthyroidism and new developments in limiting the radiation exposure to the patients with differentiated thyroid cancer.
讨论内分泌医师在使用放射性碘(RAI)治疗甲状腺功能亢进症和分化型甲状腺癌时必须做出的管理决策。
自 20 世纪 40 年代以来,放射性(131)I(RAI)治疗一直是甲状腺功能亢进症和分化型甲状腺癌治疗的主要组成部分。RAI 是治疗甲状腺功能亢进症的最常见确定性治疗方法。将与相关支持文献一起讨论包括使用抗甲状腺药物和低碘饮食在内的治疗前决策。将描述用于治疗甲状腺功能亢进症的 RAI 半定量计算方法。美国甲状腺协会(ATA)对分化型甲状腺癌的管理指南、新药的开发和最近的随机对照试验改变了目前使用 RAI 进行分化型甲状腺癌残余消融和辅助治疗的实践。
RAI 是内分泌医师治疗甲状腺功能亢进症和分化型甲状腺癌的常用工具。对 RAI 治疗管理决策和实践的回顾将使内分泌医师了解支持当前 RAI 在甲状腺功能亢进症中应用的文献,并了解限制分化型甲状腺癌患者辐射暴露的新进展。