Yoo Ik Dong, Kim Sung Hoon, Seo Ye Young, Oh Jin Kyoung, O Joo Hyun, Chung Soo Kyo
Division of Nuclear Medicine, Department of Radiology, College of Medicine, The Catholic University of Korea, Seocho-gu Banpo-dong 505, Seoul, Republic of Korea 137-040.
Nucl Med Mol Imaging. 2012 Mar;46(1):34-40. doi: 10.1007/s13139-011-0111-y. Epub 2011 Oct 8.
To decrease the risk of recurrence or metastasis in differentiated thyroid cancer (DTC), selected patients receive radioactive iodine ablation of remnant thyroid tissue or tumor. A low iodine diet can enhance uptake of radioactive iodine. We compared the success rates of radioactive iodine ablation therapy in patients who followed two different low iodine diets (LIDs).
The success rates of postsurgical radioactive iodine ablation in DTC patients receiving empiric doses of 150 mCi were retrospectively reviewed. First-time radioactive iodine ablation therapy was done in 71 patients following less strict LID and 90 patients following very strict LID. Less strict LID restricted seafood, iodized salt, egg yolk, dairy products, processed meat, instant prepared meals, and multi-vitamins. Very strict LID additionally restricted rice, freshwater fish, spinach, and soybean products. Radioactive iodine ablation therapy was considered successful when follow-up (123)I whole body scan was negative and stimulated serum thyroglobulin level was less than 2.0 ng/mL.
The success rate of patients following less strict LID was 80.3% and for very strict LID 75.6%. There was no statistically significant difference in the success rates between the two LID groups (p = 0.48).
Very strict LID may not contribute to improving the success rate of initial radioactive iodine ablation therapy at the cost of great inconvenience to the patient.
为降低分化型甲状腺癌(DTC)复发或转移的风险,部分患者接受残留甲状腺组织或肿瘤的放射性碘消融治疗。低碘饮食可增强放射性碘的摄取。我们比较了遵循两种不同低碘饮食(LIDs)的患者放射性碘消融治疗的成功率。
回顾性分析接受150毫居里经验剂量的DTC患者术后放射性碘消融的成功率。71例遵循不太严格低碘饮食的患者和90例遵循非常严格低碘饮食的患者接受了首次放射性碘消融治疗。不太严格的低碘饮食限制海鲜、加碘盐、蛋黄、乳制品、加工肉类、即食餐和多种维生素。非常严格的低碘饮食还额外限制大米、淡水鱼、菠菜和豆制品。当随访(123)I全身扫描为阴性且刺激后的血清甲状腺球蛋白水平低于2.0纳克/毫升时,放射性碘消融治疗被认为成功。
遵循不太严格低碘饮食的患者成功率为80.3%,遵循非常严格低碘饮食的患者成功率为75.6%。两组低碘饮食患者的成功率无统计学显著差异(p = 0.48)。
非常严格的低碘饮食可能不会以给患者带来极大不便为代价来提高初次放射性碘消融治疗的成功率。