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。
Cancer incidence and mortality following treatment of hyperthyroidism with radioactive iodine.
机构信息
Division of Endocrinology and Metabolism, Department of Internal Medicine, University of North Carolina, Chapel Hill, North Carolina.
Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.
出版信息
Curr Opin Endocrinol Diabetes Obes. 2020 Oct;27(5):323-328. doi: 10.1097/MED.0000000000000561.
PURPOSE OF REVIEW
Hyperthyroidism is a commonly encountered clinical issue. Radioactive iodine is one of the treatment modalities employed over the last 80 years. Prior studies are conflicting as to whether radioactive iodine is associated with an increased risk of subsequent malignancy and associated mortality. The present article reviews recent publications on this subject.
RECENT FINDINGS
Two recent studies make meaningful contributions to the existing literature; however, data remain inconsistent. The first, conducted using the Clalit Health Services database, evaluated solid tumor incidence after radioactive iodine and found no association with increased risk of solid tumor malignancy. The second, which is an updated analysis of the Cooperative Thyrotoxicosis Therapy Follow-up Study, concluded that there is a dose-dependent increased risk of solid tumor mortality using a novel method of estimating organ-specific radiation exposure.
SUMMARY
In patients with hyperthyroidism, radioactive iodine is a popular and effective treatment option. Prior studies reach conflicting conclusions on the potential relationship between radioactive iodine and both subsequent cancer incidence and mortality. We review recent publications that add to our understanding of this important clinical question.
目的综述
甲状腺功能亢进症是一种常见的临床问题。放射性碘是过去 80 年来应用的治疗方法之一。既往研究对于放射性碘是否与随后发生恶性肿瘤和相关死亡率的风险增加相关存在争议。本文对该主题的最新出版物进行了综述。
最近的发现
两项最近的研究对现有文献做出了有意义的贡献；然而，数据仍然不一致。第一项研究使用克拉利特健康服务数据库评估了放射性碘治疗后实体瘤的发生率，并未发现与实体瘤恶性肿瘤风险增加相关。第二项研究是对合作甲状腺毒症治疗随访研究的更新分析，得出的结论是，使用一种新的估计特定器官辐射暴露的方法，放射性碘的剂量与实体瘤死亡率的增加呈剂量依赖性。
总结
在甲状腺功能亢进症患者中，放射性碘是一种流行且有效的治疗选择。既往研究对放射性碘与随后发生癌症的发生率和死亡率之间的潜在关系得出了相互矛盾的结论。我们回顾了最近的出版物，这些出版物增加了我们对这一重要临床问题的理解。
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