OUTCOME OF RADIOIODINE TREATMENT IN GRAVES’ DISEASE PATIENTS AT SRINAGARIND HOSPITAL
Keywords:
Graves’ disease, Radioiodine, Treatment outcome, HypothyroidismAbstract
Background: Although being an effective and convenient means in the treatment of Graves’ hyperthyroidism, radioiodine-131 (131I) therapy usually provides unpredictable results with a major disadvantage of permanent hypothyroidism.
Objective: The study was conducted with the aim to explore the treatment outcomes of 131I in the patients with Graves’ disease. The obtained data would to be used in the evaluation and improvement of current management in this group of patients in our unit.
Design: Retrospective, descriptive study
Setting: Srinagarind Hospital, Faculty of Medicine, Khon Kaen University
Study methods: Reviewing medical records of patients with Graves’ disease referred for 131I therapy at our unit between June 1994 to August 2000 was performed. Three treatment outcomes were analyzed including efficacy of 131I in the treatment of hyperthyroidism with the first dose, the number of 131I dose used to cure hyperthyroidism and thyroid status of patients at the specific points of time after the last treatment dose.
Results: Nine hundred and eighty-four Graves’ disease patients (793 females, 191 males) were analyzed. In the 693 cases who were followed up and evaluated for the result of treatment with determinable outcome, 247 cases (35.6%) were cured from hyperthyroidism with the first dose of 131I. Of all 449 cases with adequate follow-up, 291 (64.8%) and 116 cases (25.8%) were cured by one and two doses of 131I respectively, leaving nearly 10% of patients having to be retreated with additional dose. In evaluating thyroid status, incidence of persistent hyperthy- roidism decreased from 45.6% after the first year to 13.9% at the end of the fifth year while incidence of permanent hypothyroidism tended to rise from 9.3% after the first year to 28.1% and 22.2% at the end of the forth and the fifth year respectively.
Conclusion: Our study revealed that outcomes of 131I therapy in patients with Graves’ disease were rather unpredictable. We think that the aim of treatment should be more stressed on the earlier cure of hyperthyroidism rather than the avoidance of inevitable permanent hypothyroidism. Our dosage regimen therefore should be reconsidered to achieve a higher dose of radioiodine to cure hyperthyroidism within an earlier period and by a lower number of treatment dose.
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