Delisle M J, Clerc J
Institut Jean Godinot, Reims.
Ann Endocrinol (Paris). 1997;58(3):197-203.
Retrospective studies justified the use of 131 iodine after surgery in the management of thyroid cancer for reducing recurrences and improving survival. Indications based on the evaluation of prognostic factors and on the quality of surgical excision are more advisable than systematic administration, particularly in small, non aggressive tumors which are diagnosed more and more frequently. A high level of endogenous TSH and absence of iodine overload are required. Standardized fixed ablative doses reach a high rate of success. Various scintigraphic procedures allow precise localization of residual or distant uptake. Radioprotection measures must be carefully applied to the patients and their environment by a skillful personnel. Side effects are rare after one ablation dose but must be systematically noted and treated. Genetic and carcinogenetic risks are very low.
回顾性研究证明,甲状腺癌手术后使用131碘有助于减少复发并提高生存率。基于预后因素评估和手术切除质量的适应证选择比系统性给药更可取,尤其是对于越来越常见的小的、非侵袭性肿瘤。需要高水平的内源性促甲状腺激素且不存在碘过载。标准化的固定消融剂量成功率很高。各种闪烁扫描程序可精确定位残留或远处摄取。熟练的工作人员必须对患者及其环境仔细采取辐射防护措施。一次消融剂量后副作用很少见,但必须系统记录并治疗。遗传和致癌风险非常低。