The incidence of recurrence and hypothyroidism after radioiodine treatment in patients with hyperthyroidism in Trakya, a mild iodine deficiency area, during the period 1991–2003

Üstün, Funda; Yüksel, Mahmut; Dukmus-Altun, Gülay; Kaya, Meryem; Çermjk, Tevfik Fikret; Sarıkaya, Ali; Berkarda, Şakir

doi:10.1007/bf02985126

Cited by 17 publications

(12 citation statements)

References 21 publications

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“…A third study with a large difference in administered activities showed better treatment outcome in the group receiving the highest mean activity (13). The fact that in three studies the applied activities were rather similar (16,19,21), points out that the difference between the two methods does not only lead to similar treatment effects, but that it also does not translate invariably into different applied activities.…”

Section: Discussionmentioning

confidence: 88%

“…Thyroid volume was determined by palpation in three studies, by ultrasound in two studies, by nuclear imaging methods in two studies; one study used a combination of the latter two methods. The used tracer activity for the 4-and 24-h uptake scan was reported in only four studies (10,13,18,21).…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Three studies included only patients with Graves' disease (10, 13, 16), two were restricted to patients with toxic multinodular goiter (17,18), and three included all causes of hyperthyroidism (19)(20)(21). Administered activities of I-131 ranged from 177 to 747 MBq.…”

Section: Study Characteristicsmentioning

confidence: 99%

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Clinical outcomes after estimated versus calculated activity of radioiodine for the treatment of hyperthyroidism: systematic review and meta-analysis

Rooij¹,

Vandenbroucke²,

Smit³

et al. 2009

European Journal of Endocrinology

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Background: Despite the long experience with radioiodine for hyperthyroidism, controversy remains regarding the optimal method to determine the activity that is required to achieve long-term euthyroidism. Objectives: To compare the effect of estimated versus calculated activity of radioiodine in hyperthyroidism. Design: Systematic review and meta-analysis. Methods: We searched the databases Medline, EMBASE, Web of Science, and Cochrane Library for randomized and nonrandomized studies, comparing the effect of activity estimation methods with dosimetry for hyperthyroidism. The main outcome measure was the frequency of treatment success, defined as persistent euthyroidism after radioiodine treatment at the end of follow-up in the dose estimated and calculated dosimetry group. Furthermore, we assessed the cure rates of hyperthyroidism. Results: Three randomized and five nonrandomized studies, comparing the effect of estimated versus calculated activity of radioiodine on clinical outcomes for the treatment of hyperthyroidism, were included. The weighted mean relative frequency of successful treatment outcome (euthyroidism) was 1.03 (95% confidence interval (CI) 0.91-1.16) for estimated versus calculated activity; the weighted mean relative frequency of cure of hyperthyroidism (eu-or hypothyroidism) was 1.03 (95% CI 0.96-1.10). Subgroup analysis showed a relative frequency of euthyroidism of 1.03 (95% CI 0.84-1.26) for Graves' disease and of 1.05 (95% CI 0.91-1.19) for toxic multinodular goiter. Conclusion: The two main methods used to determine the activity in the treatment of hyperthyroidism with radioiodine, estimated and calculated, resulted in an equally successful treatment outcome. However, the heterogeneity of the included studies is a strong limitation that prevents a definitive conclusion from this meta-analysis.

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Section: Discussionmentioning

confidence: 88%

Section: Study Characteristicsmentioning

confidence: 99%

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Clinical outcomes after estimated versus calculated activity of radioiodine for the treatment of hyperthyroidism: systematic review and meta-analysis

Rooij¹,

Vandenbroucke²,

Smit³

et al. 2009

European Journal of Endocrinology

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“…In three studies only multinodular toxic goiters were included (12-14). Three studies comparing fixed dose (FD) versus calculated dose (CD), included both Graves’ disease and TNG (4, 15, 16). In recent studies we extracted data for patients with toxic multinodular goiter and only analyzed that part of the trial.…”

Section: Resultsmentioning

confidence: 99%

Efficacy of Different Protocols of Radioiodine Therapy for Treatment of Toxic Nodular Goiter: Systematic Review and Meta-Analysis of the Literature

Rokni

Sadeghi

Moossavi

et al. 2014

Int J Endocrinol Metab

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Context:To evaluate treatment success and hypothyroidism following main methods of radioiodine therapy of toxic nodular goiter (TNG); calculated versus fixed dose and high versus low dose of radioiodine.Evidence Acquisitions:We searched MEDLINE and SCOPUS databases from inception till July 2013, for clinical trials that compared two different methods of radioiodine administration in TNG. The trials were classified into two groups, those that compared fixed versus calculated dosimetry method and those that assessed high fixed dose versus low fixed dose method. Treatment response was defined as euthyroidism or hypothyroidism, one year after radioiodine administration. We calculated the risk ratio and risk difference of treatment response as well as permanent hypothyroidism as outcome variables. Random effects model was used for data pooling.Results:The literature search yielded 2538 articles. Two randomized and five non-randomized clinical trials with 669 patients met the eligibility criteria for the meta-analysis. Patients with TNG who were treated according to the calculated method had 9.6% higher cure rate (risk ratio=1.17) and only 0.3% more permanent hypothyroidism compared to patients treated with the fixed dose method. There was no significant difference in the amount of administered radio-iodine in the two groups. Patients treated with fixed high dose had 18.1% more cure rate (risk ratio = 1.2) and 23.9% more permanent hypothyroidism (risk ratio = 2.40) compared to patients treated by fixed low dose protocols.Conclusions:Calculated radioiodine therapy may be preferred to fixed dose method in patients with TNG. High dose methods are associated with more response and more hypothyroidism.

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“…U većini istraživanja na ovu temu, nije pokazana znaĉajnija razlika u ishodu zavisno od korišćenja fiksnih ili kalkulisanih doza u terapiji hipertireoidizma. Ustun i saradnici primenjivali su kalkulisane i fiksne doze od 10mCi, kod tri grupe ispitanika i nisu našli znaĉajnu razliku u odnosu na krajnji ishod [22]. U istraživanju Metso i saradnika, nakon primene fiksne doze od 7mCi pacijentima sa GB, u prvoj postterapijskoj godini bilo je 24% hipotireoidnih pacijenata, a nakon 25 godina 82% [18].…”

Section: Wwwtmgorgrsunclassified

Postprocedural hypothyroidism after a single therapeutic dose of radioiodine during a 5-year follow up in Graves-Basedow disease patients treated in The Department of Nuclear Medicine Zajecar

Milicevic¹,

Aleksić²,

Aleksić³

2014

Tim Med Glas

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(1) SLUŽBA ZA NUKLEARNU MEDICINU, ZAJEĈAR (2) INTERNISTIĈKA SLUŽBA, ZAJEĈAR Sažetak:Autoimuni hipertireoidizam, poznatiji kao Grejves-Bazedovljeva bolest (GB) je tireotoksiĉno stanje nastalo zbog pojaĉanog stvaranja tireoidnih hormona, izazvano patološkom stimulacijom tireoidee TSH receptorskim antitelima. Radiojodna terapija (RIT = J-131 = RI) je terapija izbora kod pacijenta sa GB koji ne postižu remisiju tokom medikamentne tirosupresivne terapije (MTT), imaju ĉeste recidive bolesti, ili lošu komplijansu na MTT. Postproceduralni hipotireoidizam (PPH) nastaje kao dugoroĉni efekat RIT i zahteva doživotnu supstitucionu terapiju levotiroksinom. Cilj rada je bio da se retrospektivno proceni incidenca PPH kod naših pacijenata sa GB leĉenih radiojodom. Analizirani su podaci iz kartona pacijenata Registra endokrinih oboljenja Službe za nuklearnu medicinu Zdravstvenog centra Zajeĉar, leĉenih u periodu od 2002. do 2007. godine, i praćenih do 2012. godine. U ovom periodu radiojodom je leĉen 91 pacijent. Jednom dozom su leĉena 62 pacijenta i njihovi podaci su ukljuĉeni u analizu. Bilo je 8 muškaraca i 54 žene, proseĉne starosti 55,3±11,7 godina (opseg 33-83). Proseĉna doza terapijskog radiojoda iznosila je 6,6±1,7mCi (opseg 4,5-15) -srednje do umerene fiksne doze. Medijana trajanja MTT do primene radiojodne terapije, bila je 5,5 meseci, opseg (1-384). Tokom ukupnog perioda praćenja, skoro polovina (47%) pacijenata je razvila PPH, i to najveći broj tokom prve godine po dobijanju terapijske doze, njih 39%. Metodom "life-table" analize pokazana je verovatnoća nastanka PPH u prvoj postterapijskoj godini od 41%, a narednih godina 7-9% novih sluĉajeva. Prikazana je struktura pacijenata sa PHH i onih koji su ostali eutireoidni, prema polu i veliĉine strume pre primene RI, kao i proseĉna starost, proseĉno trajanje MTT i proseĉna primenjena doza RI. Rezultati ukazuju na potrebu za doživotnim praćenjem funkcijskog tireoidnog statusa pacijenata leĉenih radiojodom zbog Grejvs-Bazedovljeve bolesti. Režim srednjih do umerenih fiksnih doza ne daje veću incidencu postproceduralnog hipotireoidizma u odnosu na incidencu hipotireoidizma nakon primene kalkulisanih doza objavljenih u literaturi. Kluĉne reći:hipertireoidizam, Grejvs Bazedovljeva bolest, radiojodna terapija, postproceduralni hipotireoidizam. Summary:Autoimmune hyperthyreoidism known as Graves-Basedow disease (GD) is a thyrotoxic condition due to the excessive production of thyroid hormone, caused by pathological thyroid stimulation by TSH receptor antibodies. Radioiodine therapy (RIT=J-131=RI) is the treatment of choice in patients with GB who do not achieve remission during the tirosupressive drug therapy (MTT), who have frequent recurrences of disease or poor compliance to the MTT. Post-procedural hypothyroidism (PPH) occurs as a long-term effect of RIT and requires lifelong replacement with levothyroxine. The aim of this study was to retrospectively assess the incidence of PPH in our GD patients treated with RIT. We analyzed data from patients' Registery book for endocrine d...

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The incidence of recurrence and hypothyroidism after radioiodine treatment in patients with hyperthyroidism in Trakya, a mild iodine deficiency area, during the period 1991–2003

Cited by 17 publications

References 21 publications

Clinical outcomes after estimated versus calculated activity of radioiodine for the treatment of hyperthyroidism: systematic review and meta-analysis

Clinical outcomes after estimated versus calculated activity of radioiodine for the treatment of hyperthyroidism: systematic review and meta-analysis

Efficacy of Different Protocols of Radioiodine Therapy for Treatment of Toxic Nodular Goiter: Systematic Review and Meta-Analysis of the Literature

Postprocedural hypothyroidism after a single therapeutic dose of radioiodine during a 5-year follow up in Graves-Basedow disease patients treated in The Department of Nuclear Medicine Zajecar

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