Efficacy of Radioiodine Therapy in Patients With Primary Hyperthyroidism: An Institutional Review From Pakistan (original) (raw)
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Failure of Radioactive Iodine in the Treatment of Hyperthyroidism
Annals of Surgical Oncology, 2014
Introduction-Persistent or recurrent hyperthyroidism after treatment with radioactive iodine (RAI) is common, and many patients require either additional doses or surgery before they are cured. The purpose of this study was to identify patterns and predictors of failure of RAI in patients with hyperthyroidism. Methods-We conducted a retrospective review of patients treated with RAI from 2007-2010. Failure of RAI was defined as receipt of additional dose(s) and/or total thyroidectomy. Using a Cox proportional hazards model, we conducted univariate analysis to identify factors associated with failure of RAI. A final multivariate model was then constructed with significant (p < 0.05) variables from the univariate analysis. Results-Of the 325 patients analyzed, 74 patients (22.8%) failed initial RAI treatment. 53 (71.6%) received additional RAI, 13 (17.6%) received additional RAI followed by surgery, and the remaining 8 (10.8%) were cured after thyroidectomy. The percentage of patients who failed decreased in a step-wise fashion as RAI dose increased. Similarly, the incidence of failure increased as the presenting T3 level increased. Sensitivity analysis revealed that RAI doses < 12.5 mCi were associated with failure while initial T3 and free T4 levels of at least 4.5 pg/mL and 2.3 ng/dL, respectively, were associated with failure. In the final multivariate analysis, higher T4 (HR 1.13, 95% CI 1.02-1.26, p=0.02) and methimazole treatment (HR 2.55, 95% CI 1.22-5.33, p=0.01) were associated with failure. Conclusions-Laboratory values at presentation can predict which patients with hyperthyroidism are at risk for failing RAI treatment. Higher doses of RAI or surgical referral may prevent the need for repeat RAI in selected patients.
Malecular Imaging and Radionuclide Therapy, 2013
Objective: Using radioactive iodine (RAI) as the first line therapy for Graves' hyperthyroidism and as the treatment of choice for relapsed Graves' disease is increasing in recent times. However, there has been little consensus on the most appropriate dose to use. So this study is to determine the response of hyperthyroidism to fixed doses of 370 MBq and 555 MBq RAI therapies and determine the incidence of hypothyroidism at 6 months post therapy. Methods: Hyperthyroid patients' case records treated with radioiodine was retrospectively reviewed to determine the response rate of hyperthyroidism to the two fixed dose regimens. Statistical analysis was done with SPSS version 15.0 and the level of statistical significance was taken as p<0.05. Forty subjects, 6 males (15%) and 34 females (85%) received RAI therapy for Graves' hyperthyroidism, mean age was 49.4 years (range, 25-75years). The thyroid function status at 6 months post therapy was available for all subjects. 24 patients (60%) received 370 MBq while 16 patients (40%) received 555 MBq. Results: The response for fixed doses of 370 MBq and 555 MBq were similar (100%). Also, the incidence of hypothyroidism in these subjects which was 66.6% with fixed dose of 370 MBq and 62.5% with fixed dose of 555 MBq within 6 months post RAI therapy were similar. Conclusion: SRAI is highly effective for the treatment of hyperthyroidism, with a cure rate of 100%. However, it has proved impossible to determine a fixed dose regimen for individual patients accurately to guarantee an euthyroid state. This is because hypothyroidism is a natural predictable sequel of RAI therapy.
Efficacy of radioiodine in the treatment of primary hyperthyroidism
Ibnosina Journal of Medicine and Biomedical Sciences
Background: Radioiodine (RI) is a commonly used treatment modality for primary hyperthyroidism. A single dose of RI has been reported to cure hyperthyroidism in the range of 50%–90% of the treated cases. The efficacy of RI treatment has not yet been investigated in the local population. Objectives: To assess the efficacy of RI therapy in patients with primary hyperthyroidism treated at Tawam Hospital, Al Ain, UAE. Patients and Methods: The electronic medical records of hyperthyroid patients who received RI treatment at Tawam Hospital between January 2009 and March 2017 were reviewed. The diagnosis was verified by reviewing clinical, laboratory, and imaging data. Following RI therapy, a cure was defined as the development of hypothyroidism or euthyroid status without the aid of antithyroid drugs (ATDs) within 6 months post-RI therapy. Multivariate analysis was used to assess predictors of RI response. Results: A total of 125 patients (68.8% women) met the study criteria. The mean age...
Bangladesh Journal of Nuclear Medicine
Background: Whileradioactive iodine therapy (RAIT) in patients with primary hyperthyroidism results in euthyreosis or hypothyreosis, requirement of repeated therapy in a proportion of patients is a clinical reality. This study describesbiochemical outcomeof patients requiring repeated RAIT and the dose profiles across the demographic traits. Patients and Methods: The study retrospectively included the patients who underwent RAIT for Primary hyperthyroidism from January to December of 2006, using a modified fixed dose protocol following an institutional guideline which was adopted as the national guideline in 2007. Persistence of biochemical features of hyperthyroidism six months after RAIT was an indication for repeated therapy. Follow up data of eligible patients till December of 2016 was included in the descriptive statistics. Results: One, Two, three and four instances of RAIT were given to 83%, 14%, 2% and ≤ 1% of patients resulting in hypothyroidism to 58%, 67%, 67% and 100% of...
Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine, 2009
To evaluate the efficacy of a fixed dose of radioactive iodine (131-I) in the treatment of thyrotoxicosis, and to identify risk factors associated with treatment failure. Retrospective study. Thyroid Clinic of a regional hospital in Hong Kong. Patients receiving their first dose of radioactive iodine for the treatment of thyrotoxicosis during the inclusive period September 1999 to August 2004. Relapse rate and time to relapse. A total of 113 patients received a fixed dose of 5 mCi (185 MBq), 6 mCi (222 MBq), 8 mCi (296 MBq), and 10 mCi (370 MBq) 131-I in a proportion of 1:6:71:35. At 1 year, 42 (37%) of the patients had relapsed, of which 69% received a second 131-I dose. The median time to relapse after first receiving 131-I was 4 months. At 1 year, the remaining 71 (63%) of the patients were successfully treated; 46 (41%) were euthyroid, and 25 (22%) had became permanently hypothyroid. Basal free thyroxine level and goitre size were significantly associated with a relapse rate aft...