Efficacy RAI in patients with Graves disease using different methods calculation of optimum therapeutic activity I131
Olga Nechaeva, Alexander Dreval, Irina Chikh, Irina Komerdus & Tatiana Shestakova
The aim of the study is to compare efficacy of RAI in patients with Graves disease using different methods calculation of optimum therapeutic activity.
Methods: About 60 patients (50 women, 10 men, mean age 44.8±11.8 years) with Graves decease were treated with RAI. The treatment with ATD was cancel 10 days before RAI to restore the iodine intake by thyroid gland. Therapeutic activity was determent individually 1) with applied the special formula in which the volume of a thyroid gland (V) and capture of diagnostic activity of radioiodine in 24 h (C) was taken into account. 2) with applied absorbed dose (for the formation in thyroid gland absorbed dose 100150 Gray). Patients who got rated dose broken into two part: Group A 20 patients who got activity I131 less 0.3 mCu/ml (middle dose 10.7±7.1 mCu) and B 20 patients who got activity I131 more 0.3 mCu per tissue thyroid gland (middle dose 12.7±4.7 mCu). Group C 20 patients who got dose I131 taking into account absorbed dose thyroid gland (middle dose 13.0±5.7 mCu).
The results: Group A: before RAI the median of TV was 35.3 ml (23.8;56.9); in 12 month 8.9 (6.3;11.6). Group B: before RAI treatment the median of TV was 30.8 ml (24.1;47.9); in 12 month 6.1 (2.9;8.9). Group C: before RAI treatment the median of TV was 45.5 ml (35.7;63.5); in 12 month 14.3 (12.0;16.6).
In 12 month after RAI in group A 7(35%) patients became euthyroid, 7(35%) patients remained thyrotoxic, 6(30%) patient had hypothyroidism. Group B 3(15%) patients became euthyroid, 3(15%) patients remained thyrotoxic, 14(70%) patient had hypothyroidism. Group C 5(25%) patients became euthyroid, 2(10%) patients remained thyrotoxic, 13(65%) patient had hypothyroidism.
Conclusion: Its reasonable to apply the therapeutic dose more then 0.3 mCu per 1 ml thyroid volume to achieve good results.