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不同放射性碘剂量用于甲状腺残留组织消融后治疗的评估:一项系统综述

Assessment of Different Radioiodine Doses for Post-ablation Therapy of Thyroid Remnants: A Systematic Review.

作者信息

Ansari Mojtaba, Rezaei Tavirani Mostafa

机构信息

Faculty of Medicine, Imam Hosein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Proteomics Research Center, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Iran J Pharm Res. 2022 May 14;21(1):e123825. doi: 10.5812/ijpr-123825. eCollection 2022 Dec.

Abstract

The determination of radioiodine remnant ablation (RRA) dosage in post-operation thyroid residual tissues resection has been largely subject of discussion, yet no concise conclusion is released through systematic review studies. In this study, we conducted a systematic review of comparative experiments to evaluate and compare the efficacy of different prescribed dosages of radioiodine in post-op thyroid residual tissues resection among low, intermediate, and high-risk patients to approve the common method. Using automated searches, studies were collected from PubMed, Google Scholar, Elsevier, Scopus, and UpToDate, all until April 2021. Alongside the aforementioned sources, comparative experiments were added in for further investigation. Overall, 4000 patients with papillary thyroid cancer, differentiated thyroid carcinoma (DTC), metastasized and non-metastasized thyroid cancer took part in twenty-one trials are assessed. We discovered no significant difference in successful thyroid residual tissues excision between low-activity and high-activity radioiodine treatment in people with low and intermediate risk. In these individuals, there was no significant difference between the high therapeutic dose of 3700 MBq and the lesser dose of 1850 MBq for RRA. However, high-dose treatment usually yielded superior results. Low activity RRA causes fewer adverse effects in metastasis-free patients than high-activity 3.7 GBq. There was no significant therapeutic difference regarding treatment efficacy in patients with low and moderate risks. However, in patients with high-risk status, applying a high-dose regimen of RRA produced a significantly better response.

摘要

甲状腺残余组织切除术后放射性碘残留消融(RRA)剂量的确定一直是讨论的焦点,但系统评价研究尚未得出明确结论。在本研究中,我们对比较实验进行了系统评价,以评估和比较低、中、高风险患者甲状腺残余组织切除术后不同规定剂量放射性碘的疗效,以验证常用方法。通过自动检索,从PubMed、谷歌学术、爱思唯尔、Scopus和UpToDate收集研究,截至2021年4月。除上述来源外,还增加了比较实验进行进一步研究。总体而言,4000例甲状腺乳头状癌、分化型甲状腺癌(DTC)、转移和未转移甲状腺癌患者参与了21项试验并接受评估。我们发现,低风险和中风险患者中,低活性和高活性放射性碘治疗在甲状腺残余组织切除成功率方面无显著差异。在这些患者中,RRA的高治疗剂量3700 MBq和较低剂量1850 MBq之间无显著差异。然而,高剂量治疗通常产生更好的结果。对于无转移患者,低活性RRA比高活性3.7 GBq产生的不良反应更少。低风险和中风险患者在治疗效果方面无显著治疗差异。然而,在高风险患者中,应用高剂量RRA方案产生的反应明显更好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/440b/9420215/6fcce0dddbea/ijpr-21-1-123825-i001.jpg

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