Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
J Endocrinol Invest. 2021 Mar;44(3):541-545. doi: 10.1007/s40618-020-01339-w. Epub 2020 Jun 24.
To assess the success rate of first dose radioiodine for treatment of hyperthyroidism in children and adolescent.
This is a retrospective data analysis of children and adolescent with hyperthyroidism who received radioiodine (RAI) therapy from January 2013 to December 2017. Age, gender, family history of hyperthyroidism, duration of anti-thyriod drugs (ATDs) treatment, rapid turnover status, 2 h and 24 h I-131 radioiodine uptake (RAIU), thyroid volume, and treatment dose were also analyzed. The goal of RAI therapy was to achieve hypothyroidism within 3-6 months after treatment. Treatment result was evaluated at 6 months after treatment and divided into 2 groups: treatment success (hypothyroid and euthyroid) and treatment failure (hyperthyroid). The same parameters were compared between both groups.
32 hyperthyroid patients, 26 female with mean age at treatment of 13.84 ± 1.83 years. All patients had prior treatment with ATDs, with a median treatment duration of 32.5 months (range 2-108). The median estimated thyroid gland size was 24.62 g, range 9.29-72.8. RAI doses ranged from 4.1 to 29.9 mCi (median dose = 7.54 mCi). Significant difference in 24-h I-131 uptake and RI status was demonstrated. Successful treatment rate after single dose of therapeutic I-131 was 65.63%.
With the I-131 dose of 220 μCi/g of thyroid tissue, successful treatment rate after single dose of therapeutic I-131 was 65.63%. RAI therapy with I-131 dose of 250-400 μCi/g of thyroid tissue might be suitable in patients with medical failure from ATDs. Possible role of RI as the predictor for RAI therapy failure are needed to investigate in both adult and children clinical settings.
评估儿童和青少年甲亢患者首剂放射性碘治疗的成功率。
这是一项回顾性数据分析，纳入了 2013 年 1 月至 2017 年 12 月期间接受放射性碘（RAI）治疗的儿童和青少年甲亢患者。分析的参数包括年龄、性别、甲亢家族史、抗甲状腺药物（ATD）治疗时间、快速代谢状态、2 小时和 24 小时 I-131 放射性碘摄取率（RAIU）、甲状腺体积和治疗剂量。RAI 治疗的目标是在治疗后 3-6 个月内实现甲状腺功能减退。治疗结果在治疗后 6 个月进行评估，并分为两组：治疗成功（甲状腺功能减退和甲状腺功能正常）和治疗失败（甲状腺功能亢进）。比较两组之间的相同参数。
32 例甲亢患者，女性 26 例，平均治疗年龄为 13.84±1.83 岁。所有患者均有 ATD 治疗史，中位治疗时间为 32.5 个月（范围 2-108 个月）。估计甲状腺大小的中位数为 24.62g，范围 9.29-72.8g。RAI 剂量范围为 4.1-29.9mCi（中位数剂量=7.54mCi）。24 小时 I-131 摄取率和 RI 状态存在显著差异。单剂治疗 I-131 的治疗成功率为 65.63%。
对于甲状腺组织 220μCi/g 的 I-131 剂量，单剂治疗 I-131 的治疗成功率为 65.63%。对于 ATD 治疗失败的患者，RAI 治疗中甲状腺组织的 I-131 剂量为 250-400μCi/g 可能是合适的。需要在成人和儿童临床环境中研究 RI 作为 RAI 治疗失败的预测因子的可能作用。
