Madu Nneka M, Skinner Catherine, Oyibo Samson O
General Practice, Peterborough City Hospital, Peterborough, GBR.
Radiotherapy, Peterborough City Hospital, Peterborough, GBR.
Cureus. 2022 Aug 23;14(8):e28316. doi: 10.7759/cureus.28316. eCollection 2022 Aug.
Introduction Radioactive iodine (RAI) has been used to treat hyperthyroidism for more than 70 years. Cure rates after RAI therapy range between 80% and 100%, with some patients requiring two or more doses. There is continued debate over which dosing regimen is optimal. We evaluated our cure rates after giving a single dose of radioactive iodine to treat hyperthyroidism using the fixed-dose regimen as opposed to the calculated-dose regimen. Materials and methods We retrospectively reviewed the clinical records of patients who had received their first single dose of RAI between 2016 and 2021. The patients had clinical and biochemical assessments every six weeks until six months post-RAI therapy, then every three months thereafter, if still not cured. Patients were deemed cured if they developed persistent hypothyroidism or euthyroidism after a single dose of RAI. The data included baseline demographics, adverse events, and cure rates after RAI treatment. Results One hundred and thirty-eight patients received their first dose of RAI during the study period. Their mean ± standard deviation (SD) age was 56.9 ± 15.3 years, and there were 101 women and 37 men. The median duration of hyperthyroidism was 34 months, and 62% of the cases were affected by Graves' disease. A majority of patients (90%) were on an antithyroid drug prior to RAI therapy. The median (interquartile range) dose of RAI received by the group was 559 (546-577) megabecquerels (MBq). Four patients (2.9%) reported adverse events shortly after receiving RAI. Our overall cure rate was 87.7% amongst patients who received a single dose of RAI therapy. This number consisted of 96 patients (69.6%) who developed hypothyroidism and 25 patients (18.1%) who remained euthyroid. Our one-year cure rate was 84.1%. Further analysis revealed that women had a greater cure rate than men over the study period (92% vs 75.7%, p = 0.017). Conclusion We have evaluated cure rates after a single dose of RAI therapy for the treatment of hyperthyroidism at our center. Our results are comparable to those reported at other centers using a similar dosing regimen.
引言 放射性碘（RAI）用于治疗甲状腺功能亢进已有70多年历史。RAI治疗后的治愈率在80%至100%之间，一些患者需要两剂或更多剂量。关于哪种给药方案最佳仍存在争议。我们评估了采用固定剂量方案而非计算剂量方案给予单剂量放射性碘治疗甲状腺功能亢进后的治愈率。
材料与方法 我们回顾性分析了2016年至2021年间接受首剂单剂量RAI治疗患者的临床记录。患者在RAI治疗后每六周进行临床和生化评估，直至治疗后六个月，之后若仍未治愈则每三个月评估一次。若患者在单剂量RAI治疗后出现持续性甲状腺功能减退或甲状腺功能正常，则视为治愈。数据包括基线人口统计学资料、不良事件以及RAI治疗后的治愈率。
结果 在研究期间，138例患者接受了首剂RAI治疗。他们的平均年龄±标准差为56.9±15.3岁，其中女性101例，男性37例。甲状腺功能亢进的中位病程为34个月，62%的病例为格雷夫斯病。大多数患者（90%）在RAI治疗前服用抗甲状腺药物。该组患者接受的RAI中位（四分位间距）剂量为559（546 - 577）兆贝可（MBq）。4例患者（2.9%）在接受RAI治疗后不久报告了不良事件。接受单剂量RAI治疗的患者总体治愈率为87.7%。其中96例患者（69.6%）出现甲状腺功能减退，25例患者（18.1%）甲状腺功能保持正常。我们的一年治愈率为84.1%。进一步分析显示，在研究期间女性的治愈率高于男性（92%对75.7%，p = 0.017）。
结论 我们评估了本中心单剂量RAI治疗甲状腺功能亢进后的治愈率。我们的结果与其他采用类似给药方案的中心报告的结果相当。
