Maxon H R
Med Clin North Am. 1985 Sep;69(5):1049-61. doi: 10.1016/s0025-7125(16)31005-7.
Ionizing radiation has been demonstrated to result in a number of changes in the human thyroid gland. At lower radiation dose levels (between 10 and 1500 rads), benign and malignant neoplasms appear to be the dominant effect, whereas at higher dose levels functional changes and thyroiditis become more prevalent. In all instances, the likelihood of the effect is related to the amount and type of radiation exposure, time since exposure, and host factors such as age, sex, and heredity. The author's current approach to the evaluation of patients with past external radiation therapy to the thyroid is shown in Figure 1. The use of prophylactic thyroxine (T4) therapy is controversial. While T4 therapy may not be useful in preventing carcinogenesis when instituted many years after radiation exposure, theoretically T4 may block TSH secretion and stimulation of damaged cells to undergo malignant transformation when instituted soon after radiation exposure.
已证实电离辐射会导致人类甲状腺发生多种变化。在较低辐射剂量水平（10至1500拉德之间），良性和恶性肿瘤似乎是主要影响，而在较高剂量水平，功能变化和甲状腺炎则更为普遍。在所有情况下，出现这种影响的可能性与辐射暴露的量和类型、暴露后的时间以及年龄、性别和遗传等宿主因素有关。作者目前对过去接受过甲状腺外照射治疗的患者进行评估的方法如图1所示。预防性甲状腺素（T4）治疗的使用存在争议。虽然在辐射暴露多年后开始使用T4治疗可能对预防致癌作用无用，但理论上在辐射暴露后不久开始使用T4可能会阻断促甲状腺激素（TSH）的分泌，并抑制受损细胞发生恶性转化。
