Reduction in goiter size by 131I therapy in patients with non-toxic multinodular goiter

Wesche, M. F. T.; Tiel-v-Buul, Monique M; Smits, N. J.; Wiersinga, Wilmar M.

doi:10.1530/eje.0.1320086

Cited by 54 publications

(33 citation statements)

References 6 publications

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“…In toxic multinodular goitres, in which case the primary goal is to cure hyperthyroidism, Nygaard et al (70) found a goitre reduction of 43% within 2 years. Similar results have been obtained in studies of the non-toxic multinodular goitre (71)(72)(73), with reductions ranging from 40 to 60%. The superiority of 131 I over L-T 4 has recently been shown in a randomised trial by Wesche et al (61).…”

Section: Efficacy Of 131supporting

confidence: 84%

Controversies in radioiodine therapy: relation to ophthalmopathy, the possible radioprotective effect of antithyroid drugs, and use in large goitres

Bonnema

Bartalena

Toft

et al. 2002

European Journal of Endocrinology

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In routine use for more than 50 years, radioiodine ( 131 I) is generally considered safe and devoid of major side effects. Therefore, it is surprising that relatively many aspects of radioiodine therapy are controversial, as illustrated by recent international questionnaire studies. Our review aims at highlighting three of these areas -namely, the influence of 131 I on the course of Graves' ophthalmopathy, the possible radioprotective effects of antithyroid drugs, and the use of 131 I in large goitres. 131 I therapy carries a small (but definite) risk of causing progression of Graves' ophthalmopathy. Identification of risk factors (thyroid dysfunction, high level of thyroid-stimulating hormone (TSH) receptor antibodies, cigarette smoking) allows the identification of patients at risk and the institution of concomitant glucocorticoid treatment, thereby hindering progression of eye disease.On the basis, largely, of retrospective data, it appears that carbimazole (or methimazole), if stopped 3-5 days before treatment, does not influence the outcome of 131 I therapy. Simultaneous thyrostatic medication most probably reduces the efficacy of 131 I, as does restarting it within 7 days. Propylthiouracil seems to have a more prolonged radioprotective effect than carbimazole.Surgery is the treatment of first choice in patients with a large goitre. However, in the case of patient ineligibility or preference, 131 I therapy may be an option. The treatment has a favourable effect on tracheal compression and inspiratorycapacity, but the reduction in thyroid volume is only 30-40%. Inpatient treatment, necessitated by the large doses, makes the treatment cumbersome.Controversy related to radioiodine therapy is mainly based on the lack of adequate prospective randomised studies comparing efficacy, side effects, cost and patient satisfaction.

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Section: Efficacy Of 131supporting

confidence: 84%

Controversies in radioiodine therapy: relation to ophthalmopathy, the possible radioprotective effect of antithyroid drugs, and use in large goitres

Bonnema

Bartalena

Toft

et al. 2002

European Journal of Endocrinology

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“…We observed that patients with hypothyroidism after the treatment initially had higher TSH and lower fT4 levels. These results confirm the conclusions drawn by Wesche et al that subclinical hyperthyroidism is a protective factor against hypothyroidism after 131-I treatment [26].…”

Section: Discussionsupporting

confidence: 93%

Wole guzowate olbrzymie — ambulatoryjne leczenie radiojodem

Kaniuka-Jakubowska

Lewczuk

Mizan-Gross

et al. 2015

Endokrynologia Polska

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Introduction: 131-I treatment of nodular, especially nontoxic, goitre is still reserved mainly for elderly patients, whose numerous concomitant diseases disqualify them from surgery. Therapy often involves isolation and is available only in selected centres, which may be located far from some patients' places of residence, which is inconvenient for elderly people. The aim of the study was to assess the effectiveness of outpatient fractionated 131-I treatment of patients with large nodular goitres, as well as to evaluate complications and the factors affecting treatment results. Material and methods:The study included 35 patients with a large nodular goitre. Thyroid volume and treatment results were evaluated using US and CT neck examination.

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“…The use of radioactive iodine ( 131 I) for MNG treatment has been described in several studies, showing a goiter size reduction ranging from 34 to 49% in the first year (7)(8)(9)(10)(11)(12)(13)(14). Most of this reduction occurs during the first three months after 131 I therapy (12).…”

Section: Introductionmentioning

confidence: 99%

Effect of 30 mCi radioiodine on multinodular goiter previously treated with recombinant human thyroid-stimulating hormone

Paz-Filho

Mesa-Junior

Olandoski

et al. 2007

Braz J Med Biol Res

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Recombinant human thyroid-stimulating hormone (rhTSH) enhances 131 I uptake, permitting a decrease in radiation for the treatment of multinodular goiter (MNG). Our objective was to evaluate the safety and efficacy of a single 0.1-mg dose of rhTSH, followed by 30 mCi 131 I, in patients with MNG. Seventeen patients (15 females, 59.0 ± 13.1 years), who had never been submitted to 131 I therapy, received a single 0.1-mg injection of rhTSH followed by 30 mCi 131 I on the next day. Mean basal thyroid volume measured by computed tomography was 106.1 ± 64.4 mL. 131 I 24-h uptake, TSH, free-T4, T3, thyroglobulin, anti-thyroid antibodies, and thyroid volume were evaluated at regular intervals of 12 months. Mean 131 I 24-h uptake increased from 18.1 ± 9.7 to 49.6 ± 13.4% (P < 0.001), a median 2.6-fold increase (1.2 to 9.2). Peak hormonal levels were 10.86 ± 5.44 mU/L for TSH (a median 15.5-fold increase), 1.80 ± 0.48 ng/dL for free-T4, 204.61 ± 58.37 ng/dL for T3, and a median of 557.0 ng/mL for thyroglobulin. The adverse effects observed were hyperthyroidism (17.6%), painful thyroiditis (29.4%) and hypothyroidism (52.9%). Thyroid volume was reduced by 34.3 ± 14.3% after 6 months (P < 0.001) and by 46.0 ± 14.6% after 1 year (P < 0.001). Treatment of MNG with a single 0.1-mg dose of rhTSH, followed by a fixed amount of radioactivity of 131 I, leads to an efficacious decrease in thyroid volume for the majority of the patients, with a moderate incidence of non-serious and readily treatable adverse effects.

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Reduction in goiter size by 131I therapy in patients with non-toxic multinodular goiter

Cited by 54 publications

References 6 publications

Controversies in radioiodine therapy: relation to ophthalmopathy, the possible radioprotective effect of antithyroid drugs, and use in large goitres

Controversies in radioiodine therapy: relation to ophthalmopathy, the possible radioprotective effect of antithyroid drugs, and use in large goitres

Wole guzowate olbrzymie — ambulatoryjne leczenie radiojodem

Effect of 30 mCi radioiodine on multinodular goiter previously treated with recombinant human thyroid-stimulating hormone

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