What is the best pre-therapeutic dosimetry for successful radioiodine therapy of multifocal autonomy?
| Autor: | Artur Bauhofer, C. Rubner, Wim J.G. Oyen, Frans H.M. Corstens, A. Pfestroff, Anja Schlieck, T. M. Behr, F. Berce, J. Goecke, Martin Gotthardt, Martin Béhé |
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| Rok vydání: | 2006 |
| Předmět: |
Male
Dose calculation medicine.medical_treatment Aetiology screening and detection [ONCOL 5] Hyperthyroidism Iodine Radioisotopes Reference Values Translational research [ONCOL 3] medicine Dosimetry Humans Radiology Nuclear Medicine and imaging Retrospective Studies business.industry Thyroid Radioiodine therapy Retrospective cohort study Dose-Response Relationship Radiation Immunotherapy gene therapy and transplantation [UMCN 1.4] General Medicine Functional imaging [IGMD 1] Target dose Radiation therapy Pathogenesis and modulation of inflammation [N4i 1] medicine.anatomical_structure Treatment Outcome Reference values Female business Nuclear medicine Half-Life |
| Zdroj: | Nuklearmedizin. Nuclear Medicine, 45, 5, pp. 206-12 Nuklearmedizin. Nuclear Medicine, 45, 206-12 ResearcherID Europe PubMed Central |
| ISSN: | 0029-5566 |
| Popis: | Item does not contain fulltext PURPOSE: Dose calculation for radioiodine therapy (RIT) of multifocal autonomies (MFA) is a problem as therapeutic outcome may be worse than in other kinds of autonomies. We compared different dosimetric concepts in our patients. PATIENTS, METHODS: Data from 187 patients who had undergone RIT for MFA (Marinelli algorithm, volumetric compromise) were included in the study. For calculation, either a standard or a measured half-life had been used and the dosimetric compromise (150 Gy, total thyroid volume). Therapeutic activities were calculated by 2 alternative concepts and compared to therapeutic success achieved (concept of TcTUs-based calculation of autonomous volume with 300 Gy and TcTUs-based adaptation of target dose on total thyroid volume). RESULTS: If a standard half-life is used, therapeutic success was achieved in 90.2% (hypothyroidism 23,1%, n = 143). If a measured half-life was used the success rate was 93.1% (13,6% hypothyroidism, n = 44). These differences were statistically not significant, neither for all patients together nor for subgroups eu-, hypo-, or hyperthyroid after therapy (ANOVA, all p > 0.05). The alternative dosimetric concepts would have resulted either in significantly lower organ doses (TcTUs-based calculation of autonomous volume; 80.76 +/- 80.6 Gy versus 125.6 +/- 46.3 Gy; p < 0.0001) or in systematic over-treatment with significantly higher doses (TcTUs-adapted concept; 164.2 +/- 101.7 Gy versus 125.6 +/- 46.3 Gy; p = 0.0097). CONCLUSIONS: TcTUsbased determination of the autonomous volume should not be performed, the TcTUs-based adaptation of the target dose will only increase the rate of hypothyroidism. A standard half-life may be used in pre-therapeutic dosimetry for RIT of MFA. If so, individual therapeutic activities may be calculated based on thyroid size corrected to the 24h ITUs without using Marinelli's algorithm. |
| Databáze: | OpenAIRE |
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