Pregledni rad
Postoperative Use of Radioiodine (131-I): Review of Recommendations and Guidelines
Marin Prpić
Tomislav Jukić
Jure Murgić
Marta Borić
Josip Staničić
Zvonko Kusić
Sažetak
In the management of large number of patients with differentiated thyroid cancer, the radioactive iodine (131-I) administration
plays an important role. The guidelines of numerous international and national medical societies regarding
the issue of postoperative 131-I administration have been published and updated in the last few years. The guidelines
differ in the shape and content, and contain some specific features. The different methods for evaluation and analysis of
clinical evidence level and resulting grades of recommendations have been used in line with the very guidelines. The
postoperative 131-I administration refers to the radioiodine ablation as a form of adjuvant treatment and radioiodine
therapy in the management of patients with recurrent cancer, persistent disease and regional or distant metastases. According
to the indications for the postoperative 131-I administration, the patients could be divided into the three risk
groups: the very low risk group in which there is no indication for the postoperative131-I administration, the low risk
group in which the indication could be considered, and the high risk group in which there is a clear indication for
the131-I administration. The different criteria for distribution of patients into these three groups are expressed in a certain
guidelines. There are different opinions about the necessary dosage of 131-I for the efficient ablation in the low risk
group. Moreover, the opinions are also divided regarding the conduction of postoperative (preablative or pretherapeutic)
scintigraphy with 131-I. As regards the instructions on preparation of patients for the radioiodine ablation and therapy,
all the guidelines recommend the low iodine diet and endogenous or exogenous stimulation of TSH. The endogenous
stimulation is accomplished by the withdrawal of thyroid hormones, whereas the recombinant human TSH (rhTSH) is
used for exogenous stimulation. For conducting the therapy with 131-I the level of TSH has to be >25–30 mU/L.
Ključne riječi
differentiated thyroid cancer; thyroid remnant ablation; radioiodine therapy; guidelines; recombinant human thyrotropin
Hrčak ID:
69154
URI
Datum izdavanja:
24.6.2011.
Posjeta: 1.329 *