Enhancing the efficacy of 131I therapy in non-toxic multinodular goitre with appropriate use of methimazole: an analysis of randomized controlled study

Abstract

Purpose It is possible to raise the rate of the uptake of 131 I in the thyroid gland (RAIU) by increasing the endogenous TSH level through appropriate use of methimazole (MMI) prior to 131 I therapy. The purpose of this paper is to assess the impact of pre treatment with MMI on the efficacy of 131 I therapy in non-toxic multinodular goitre (NMG). Methods Thirty-one patients with NMG received 131 I treatment in order to reduce the volume of the thyroid (TVR). Those in group 1 (n = 16) were administered 10 mg of methimazole for 6 weeks. Four days after its discontinuation, they received 131 I. Patients in group 2 (n = 15) were given a placebo instead of MMI. The therapeutic activity of 131 I was constant (800 MBq) and was repeated every 6 months. Treatment was discontinued when TVR reached <40 ml. Results In group 1, RAIU increased approximately twofold. Ten patients from group 2 and four patients from group 1 received further doses of 131 I. The median of time until TVR decreased below 40 ml was 9 months [6-12 months] and 18 months [14-22 months] in group 2. At 2 years after the 131 I therapy, the occurrence of hypothyroidism did not differ significantly (36% in group 1 and 33% in group2, p = 0.074). Conclusions Radioiodine treatment of NMG preceded with appropriate application of MMI is efficient thanks to increased RAIU, shorter period of treatment, and lower frequency of 131 I administration, without an increase in the incidence of posttreatment hypothyroidism.

Radioactive Iodine Therapy for Hyperthyroidism

“…However, its use is only limited in treatment of thyroid cancer. ATD can be used to increase endogenous TSH seems promising and needs further studies [46].…”

Vorausschauende Entlassungskriterien nach Lu-177-PSMA-Therapie – Diskussion unterschiedlicher Szenarien

“…Palliativtherapien bei Knochenmetastasen (Re-186, Sm-153, Ra-223) sind dabei auch ambulant genehmigungsfähig [12]. Während für die prä-und intratherapeutische Dosimetrie und die Entlassungspraxis der Radioiodtherapie seit Jahrzehnten etablierte Verfahren existieren, die einer stetigen Entwicklung unterworfen sind, stehen die Peptid Rezeptor Radiotherapie (PPRT) und die Radioligandentherapie (RLT) diesbezüglich noch am Anfang der Entwicklung [13,14,15]. Seit dem Inkrafttreten der ersten Richtlinie Strahlenschutz in der Medizin wurden die Entlassungswerte kontinuierlich zu höheren Werten verschoben.…”