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放射性碘治疗与甲状腺功能亢进症患者癌症死亡率的关联备受关注,抗甲状腺药物的最高风险被忽视。

Spotlight on the Association of Radioactive Iodine Treatment With Cancer Mortality in Patients With Hyperthyroidism is Keeping the Highest Risk From Antithyroid Drugs in the Blind Spot.

机构信息

From the Section of Nuclear Medicine, Department of Radiology, Penn State Health Milton S. Hershey Medical Center, Hershey, PA.

Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN.

出版信息

Clin Nucl Med. 2019 Oct;44(10):789-791. doi: 10.1097/RLU.0000000000002792.

DOI:10.1097/RLU.0000000000002792
PMID:31453816
Abstract

July 1, 2019, JAMA Internal Medicine released online an article authored by Kitahara et al entitled "Association of radioactive iodine treatment with cancer mortality in patients with hyperthyroidism." The Altmetric Attention Score, a global indicator of interest from lay public and colleagues, skyrocketed to 223 by July 7, placing the article in the top 5% of all scored reports. The overall perception of death from cancer risk associated with I is inflated and not supported by evidence. As co-authors of this article, we offer previously unpublished data and analysis that (1) disputes clinical significance of the associated risk from I and (2) shows, again, that antithyroid drugs carry a statistically significant and a much more obvious cancer death risk.

摘要

2019 年 7 月 1 日,《美国医学会杂志-内科学》在线发表了由 Kitahara 等人撰写的题为“放射性碘治疗与甲状腺功能亢进患者癌症死亡率的关系”的文章。到 7 月 7 日,Altmetric 关注度(一个衡量公众和同行兴趣的全球指标)飙升至 223,使该文章跻身所有评分报告的前 5%。与 I 相关的癌症死亡风险的总体认知被夸大了,并且没有得到证据的支持。作为这篇文章的共同作者,我们提供了以前未发表的数据和分析,(1)质疑 I 相关风险的临床意义,(2)再次表明抗甲状腺药物具有统计学意义且更明显的癌症死亡风险。

相似文献

1
Spotlight on the Association of Radioactive Iodine Treatment With Cancer Mortality in Patients With Hyperthyroidism is Keeping the Highest Risk From Antithyroid Drugs in the Blind Spot.放射性碘治疗与甲状腺功能亢进症患者癌症死亡率的关联备受关注,抗甲状腺药物的最高风险被忽视。
Clin Nucl Med. 2019 Oct;44(10):789-791. doi: 10.1097/RLU.0000000000002792.
2
Associating radioiodine therapy in hyperthyroidism with cancer mortality: robust or random results of a statistical analysis?放射性碘治疗甲状腺功能亢进症与癌症死亡率相关:统计学分析的稳健结果还是随机结果?
Hell J Nucl Med. 2020 Jan-Apr;23(1):94-95. doi: 10.1967/s002449912018.
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Prevalence of inappropriate drug treatment in patients with hyperthyroidism.甲状腺功能亢进症患者不适当药物治疗的患病率。
Br Med J (Clin Res Ed). 1985 Nov 23;291(6507):1491-2. doi: 10.1136/bmj.291.6507.1491.
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The use of radioactive iodine in the management of hyperthyroidism in children.放射性碘在儿童甲状腺功能亢进症治疗中的应用。
Curr Drug Targets Immune Endocr Metabol Disord. 2001 Nov;1(3):255-64. doi: 10.2174/1568008013341262.
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Clinical and biochemical changes following 131I therapy for hyperthyroidism in patients not pretreated with antithyroid drugs.未预先使用抗甲状腺药物治疗的甲亢患者接受¹³¹I治疗后的临床和生化变化。
Neth J Med. 1999 Nov;55(5):215-21. doi: 10.1016/s0300-2977(99)00066-2.
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Treatment of hyperthyroidism.甲状腺功能亢进的治疗。
Annu Rev Med. 1980;31:385-404. doi: 10.1146/annurev.me.31.020180.002125.
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Radioiodine therapy for hyperthyroidism.放射性碘治疗甲状腺功能亢进症。
Drug Ther Bull. 2006 Jun;44(6):44-8. doi: 10.1136/dtb.2006.44644.
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Fractionated radioiodine therapy for hyperthyroidism caused by widespread metastatic follicular thyroid carcinoma.分次放射性碘治疗广泛转移性滤泡状甲状腺癌所致的甲状腺功能亢进症。
Thyroid. 2010 May;20(5):569-70. doi: 10.1089/thy.2009.0460.
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Hyperthyroidism due to functioning metastatic thyroid carcinoma. Precipitation of thyroid storm with therapeutic radioactive iodine.功能性转移性甲状腺癌导致的甲状腺功能亢进。治疗性放射性碘引发甲状腺危象。
JAMA. 1979 Jul 20;242(3):269-70.
10
Choice of treatment for thyrotoxicosis.甲状腺毒症的治疗选择。
Ann Chir Gynaecol. 1983;72(3):96-100.

引用本文的文献

1
Process to radioactive iodine treatment for Graves' hyperthyroidism: condemned or absolved?格雷夫斯病甲亢的放射性碘治疗流程:应受谴责还是可免责?
J Endocrinol Invest. 2025 Aug 6. doi: 10.1007/s40618-025-02653-x.
2
The EANM guideline on radioiodine therapy of benign thyroid disease.欧洲核医学学会关于放射性碘治疗良性甲状腺疾病的指南。
Eur J Nucl Med Mol Imaging. 2023 Sep;50(11):3324-3348. doi: 10.1007/s00259-023-06274-5. Epub 2023 Jul 3.
3
A Clinical Debate: What Is the Therapeutic Choice for Recurrent Graves' Hyperthyroidism?一场临床辩论:复发性格雷夫斯甲亢的治疗选择是什么?
Int J Endocrinol Metab. 2020 Oct 31;18(4):e108876. doi: 10.5812/ijem.108876. eCollection 2020 Oct.
4
Exposure to antithyroid drugs and ethylenethiourea and risk of thyroid cancer: a systematic review of the epidemiologic evidence.接触抗甲状腺药物和乙撑硫脲与甲状腺癌风险:流行病学证据的系统评价
Eur J Cancer Prev. 2022 Jan 1;31(1):64-72. doi: 10.1097/CEJ.0000000000000658.
5
Cancer incidence and mortality following treatment of hyperthyroidism with radioactive iodine.放射性碘治疗甲状腺功能亢进症后的癌症发病率和死亡率。
Curr Opin Endocrinol Diabetes Obes. 2020 Oct;27(5):323-328. doi: 10.1097/MED.0000000000000561.
6
Should radioiodine now be first line treatment for Graves' disease?放射性碘现在应该成为格雷夫斯病的一线治疗方法吗?
Thyroid Res. 2020 Mar 9;13:3. doi: 10.1186/s13044-020-00077-8. eCollection 2020.
7
"Quid autem vides festucam in oculo fratris tui et trabem in oculo tuo non vide" on the hyperthyroidism-induced mortality and antithyroid drug-induced side effects in the era of radioiodine fake news.“你为何只看见你弟兄眼中的刺,却不想自己眼中有梁木呢”:关于放射性碘时代甲状腺功能亢进症所致死亡率及抗甲状腺药物所致副作用的虚假新闻。
Eur J Nucl Med Mol Imaging. 2020 Jun;47(6):1342-1344. doi: 10.1007/s00259-020-04748-4.
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The Year in Medical Thyroidology Review: Current Challenges and Future Directions.医学甲状腺学年度综述:当前挑战与未来方向
Thyroid. 2020 Jan;30(1):13-19. doi: 10.1089/thy.2019.0792.
9
Errare humanum est, sed in errare perseverare diabolicum: methodological errors in the assessment of the relationship between I-131 therapy and possible increases in the incidence of malignancies.人孰无过,但坚持错误则属恶魔行径:¹³¹I治疗与恶性肿瘤发病率可能增加之间关系评估中的方法学错误。
Eur J Nucl Med Mol Imaging. 2020 Mar;47(3):519-522. doi: 10.1007/s00259-019-04580-5.