Beierwaltes W H
Semin Nucl Med. 1978 Jan;8(1):79-94. doi: 10.1016/s0001-2998(78)80009-9.
Radioiodine (131I) treatment of well-differentiated thyroid carcinoma is a well-evaluated therapeutic model for nuclear medicine which has never been equaled by subsequent developments. It is still a unique method of treating cancer. The treatment of thyroid cancer begins with a systematic approach to the most common first symptom or sign; a neck mass. Data have accumulated to show that well-differentiated thyroid cancer does kill commonly enough to warrant aggressive treatment, even in young individuals. There is also evidence that the more complete the thyroidectomy, the lower the death and recurrence rate of the thyroid cancer, and the more effective the use of 131I in both detecting and treating metastases. There are now considerable data demonstrating that 131I after surgery decreases both the recurrence rate and death rate from well-differentiated thyroid cancer. After uptake is "ablated", there is a 1%--2% recurrence rate in patients with the most extensive disease at the time of the initial treatment. This recurrence is effectively retreated with another dose of 131I. Surgery and 131I should be used as long as they are effective before resorting to teletherapy. There are now considerable data to show that the morbidity of surgical and 131I treatment is reasonable in contrast to the recurrence and death rate from nonaggressively treated well-differentiated thyroid carcinoma. Serious consideration should be given to using a low iodine diet before treatment with radioiodine.
放射性碘（¹³¹I）治疗分化型甲状腺癌是核医学中一种经过充分评估的治疗模式，后续的发展从未超越过它。它仍然是一种独特的癌症治疗方法。甲状腺癌的治疗始于对最常见的首发症状或体征——颈部肿块的系统处理。已有数据表明，分化型甲状腺癌确实具有较高的致死率，足以支持积极治疗，即使是在年轻患者中。也有证据表明，甲状腺切除越彻底，甲状腺癌的死亡率和复发率就越低，¹³¹I在检测和治疗转移灶方面的效果就越好。现在有大量数据表明，术后使用¹³¹I可降低分化型甲状腺癌的复发率和死亡率。在摄取被“清除”后，初始治疗时病情最广泛的患者复发率为1% - 2%。再次给予一剂¹³¹I可有效治疗这种复发。在采用远距治疗之前，只要手术和¹³¹I有效就应使用。现在有大量数据表明，与未积极治疗的分化型甲状腺癌的复发率和死亡率相比，手术和¹³¹I治疗的发病率是合理的。在进行放射性碘治疗前，应认真考虑采用低碘饮食。
