Clinical and Dosimetric Variables Related to Outcome After Treatment of Graves' Disease With 550 and 1110 MBq of I-131

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art_SAPIENZA_Clinical_and_Dosimetric_Variables_Related_to_Outcome_After_2015.PDF (182.07 KB)
Citações na Scopus
13
Tipo de produção
article
Data de publicação
2015
Editora
LIPPINCOTT WILLIAMS & WILKINS
DOI
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Scopus
Web of Science
PubMed
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Autor de Grupo de pesquisa
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Citação
CLINICAL NUCLEAR MEDICINE, v.40, n.9, p.715-719, 2015
Projetos de Pesquisa
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Fascículo
Resumo
Therapy of Graves' hyperthyroidism (HTG) with I-131 is still mostly performed on an empirical basis. The present study was carried out to evaluate clinical and dosimetric variables associated with outcome in HTG therapy, which could contribute to planning and defining the most appropriate activity to be administered. Methods Patients with HTG were randomly assigned to therapy with 555 MBq (15mci) or 1110 MBq (30 mCi) of I-131. Estimation of thyroid radiation absorbed dose was made according to MIRD methodology. Success was defined as clinical/laboratory euthyroidism or hypothyroidism one year after therapy. The association between clinical, laboratory, and dosimetric variables with 1-year outcome was measured using bivariate analysis, followed by logistic regression. Results Ninety-one patients included completed the follow-up. Therapeutic success was observed in 77 (84.6%) of them, in a greater proportion when 1110 MBq of I-131 was administered as compared with 550 MBq (94.8% vs 77.4%, P = 0.02). Besides administered activity, multivariate analysis indicated that outcome was related to patient age and gland mass. A higher therapeutic success rate was achieved with doses greater than 300 Gy as compared with doses less than 300 Gy (89% vs 60%, P = 0.01). Conclusion Administered activity, age, and gland mass were related to the outcome. Radiation absorbed dose, although not significant according to multivariate analysis, may be used as a quantitative parameter in therapy planning, with a target dose of 300 Gy. In cases where a rapid and efficient response to radioiodine treatment is required, adoption of a simplified protocol employing high activities is justified.
Palavras-chave
thyrotoxicosis, Graves' disease, iodine, nuclear medicine-treatment, dosimetry
URI
https://observatorio.fm.usp.br/handle/OPI/11621
Referências
  1. ALEVIZAKI CC, 1985, EUR J NUCL MED, V10, P450
  2. Bahn RS, 2011, THYROID, V21, P593, DOI 10.1089/thy.2010.0417
  3. Bajnok L, 1999, THYROID, V9, P865, DOI 10.1089/thy.1999.9.865
  4. Boelaert K, 2009, CLIN ENDOCRINOL, V70, P129, DOI 10.1111/j.1365-2265.2008.03291.x
  5. Bolch WE, 2009, J NUCL MED, V50, P477, DOI 10.2967/jnumed.108.056036
  6. Cardis E, 2005, J NATL CANCER I, V97, P724
  7. Collier A, 2009, HORM-INT J ENDOCRINO, V8, P273
  8. de Rooij A, 2009, EUR J ENDOCRINOL, V161, P771, DOI 10.1530/EJE-09-0286
  9. DOBYNS BM, 1953, J CLIN ENDOCR METAB, V13, P548
  10. Esfahani Armaghan Fard, 2005, Hell J Nucl Med, V8, P158
  11. Garsi JP, 2008, J NUCL MED, V49, P845, DOI 10.2967/jnumed.107.046599
  12. Grosso M, 2005, CANCER BIOTHER RADIO, V20, P218, DOI 10.1089/cbr.2005.20.218
  13. Gupta SK, 2010, INTERN MED J, V40, P854, DOI 10.1111/j.1445-5994.2010.02348.x
  14. Haase A, 2000, EXP CLIN ENDOCR DIAB, V108, P133, DOI 10.1055/s-2000-5807
  15. Leslie WD, 2003, J CLIN ENDOCR METAB, V88, P978, DOI 10.1210/jc.2002-020805
  16. Lind P, 2002, EUR J NUCL MED MOL I, V29, pS453, DOI 10.1007/s00259-002-0831-4
  17. Liu CJ, 2011, NUCL MED COMMUN, V32, P221, DOI 10.1097/MNM.0b013e3283432c5c
  18. Lucas KJ, 2000, THYROID, V10, P151, DOI 10.1089/thy.2000.10.151
  19. Meier DA, 2002, J NUCL MED, V43, P856
  20. PETERS H, 1995, EUR J CLIN INVEST, V25, P186, DOI 10.1111/j.1365-2362.1995.tb01547.x
  21. Pradhan AS, 2013, J MED PHYS, V38, P57
  22. Pusuwan Pawana, 2011, Journal of the Medical Association of Thailand, V94, P361
  23. Read CH, 2004, J CLIN ENDOCR METAB, V89, P4229, DOI 10.1210/jc.2003-031223
  24. Reinartz P, 2003, NUCL MED COMMUN, V24, P1247, DOI 10.1097/01.mnm.0000104647.79626.b4
  25. Reinhardt MJ, 2006, EUR J NUCL MED MOL I, V33, P608, DOI 10.1007/s00259-005-0051-9
  26. Rivkees SA, 2003, PEDIATRICS, V111, P745, DOI 10.1542/peds.111.4.745
  27. Santos RB, 2012, CLIN NUCL MED, V37, P241, DOI 10.1097/RLU.0b013e31823ea6e0
  28. Schiavo M, 2011, J ENDOCRINOL INVEST, V34, P201, DOI 10.3275/7408
  29. Sisson JC, 2011, THYROID, V21, P335, DOI 10.1089/thy.2010.0403
  30. Strigari L, 2011, Q J NUCL MED MOL IM, V55, P205
  31. Tarantini B, 2006, J ENDOCRINOL INVEST, V29, P594
  32. Traino AC, 2010, PHYS MEDICA, V26, P71, DOI 10.1016/j.ejmp.2009.08.003
  33. Verburg FA, 2011, NUKLEARMED-NUCL MED, V50, P93, DOI 10.3413/Nukmed-0341-10-08
  34. Wartofsky L, 1991, Thyroid, V1, P129, DOI 10.1089/thy.1991.1.129
  35. Yamashita Y, 2004, ENDOCR J, V51, P127, DOI 10.1507/endocrj.51.127
  36. Yau Joyce S. Y., 2009, Hong Kong Medical Journal, V15, P267
  37. Zheng Wei, 2012, Nucl Med Commun, V33, P97, DOI 10.1097/MNM.0b013e32834d3bb9

Coleções
Artigos e Materiais de Revistas Científicas - FM/MDR
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/43