Long-term results of two schedules of radioiodine treatment for toxic multinodular goitre

The long-term effects of two schedules of radioiodine therapy in patients with toxic multinodular goitre were evaluated. Forty-five patients (group A) were treated with low doses and 58 patients (group B) with calculated doses adjusted for thyroid weight (1.85-3.70 MBq/g) and radioactive iodine upta...

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Published inEuropean journal of nuclear medicine Vol. 20; no. 11; p. 1056
Main Authors Huysmans, D A, Hermus, A R, Corstens, F H, Kloppenborg, P W
Format Journal Article
LanguageEnglish
Published Germany 01.11.1993
Subjects
Adult
Aged
Aged, 80 and over
Female
Follow-Up Studies
Goiter, Nodular - radiotherapy
Graves Disease - radiotherapy
Humans
Hypothyroidism - epidemiology
Incidence
Iodine Radioisotopes - therapeutic use
Life Tables
Male
Middle Aged
Radiotherapy Dosage
Time Factors
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Summary:The long-term effects of two schedules of radioiodine therapy in patients with toxic multinodular goitre were evaluated. Forty-five patients (group A) were treated with low doses and 58 patients (group B) with calculated doses adjusted for thyroid weight (1.85-3.70 MBq/g) and radioactive iodine uptake. Follow-up (mean +/- SEM) was 4.3 +/- 0.2 years and 5.2 +/- 0.3 years, respectively (P > 0.1). At the end of follow-up, hyperthyroidism was successfully reversed in 73% (group A) and 88% (group B). In each group, hypothyroidism was present in 7%. The total dose per gram of thyroid tissue was not significantly different in groups A and B (2.1 +/- 0.2 vs 2.7 +/- 0.2 MBq/g). However, for patients treated with calculated doses the number of 131I administrations was significantly lower (1.3 +/- 0.1) than for patients treated with low doses (2.2 +/- 0.2), and the percentage of patients who were adequately treated with a single dose was more than twice as high (66% in group B versus 27% in group A). Euthyroidism was reached within a significantly shorter time after treatment with calculated doses (median time 0.6 years in group B vs 1.5 years in group A; life table analysis). It is concluded that radioiodine is an effective treatment for toxic multinodular goitre with a low risk of post-treatment hypothyroidism and that calculated (higher) doses appear to be preferable to low doses.
ISSN:0340-6997
DOI:10.1007/BF00173483