Abstract:
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Purpose: Radioactive iodine therapy (RAI) using I-131 is the most common form of treatment of Graves' disease in the USA. For disease recurrence after RAI, the current consensus over the past several decades is to increase the original I-131 dose by 20%. Using that approach, we encountered a significant number of patients who did not respond to the 2nd RAI dose, and required a 3rd dose for effective treatment. This prompted us to increase the dose by 50% rather than 20% for patients requiring a 2nd RAI treatment. The aim of this study is to compare the response rate of this strategy over the traditional approach of increasing the dose by only 20%.
Methods and Materials: Group 1 consisted of 24 patients with recurrent Graves' disease who required a 2nd RAI treatment, and were given a dose of RAI 20% higher than the original dose. (This was our approach prior to 1998). Group 2 consisted of 26 patients with recurrent Graves' disease, who were treated with a dose of RAI 50% higher than the original dose, from 1998 thru 2002.
Results: Of the 24 patients in Group 1, 16 (66.67%) responded to the 2nd RAI dose, and no further treatment was required, and 8 patients required a 3rd dose (calculated at 20% higher than the 2nd RAI dose), and this was effective in all 8 patients. Of the 26 patients in Group 2, 24 (92.30%) responded to the 2nd RAI dose, and only 2 required a 3rd treatment.
Conclusion: The response ratio, defined as the number of patients treated effectively by the 2nd RAI dose divided by all patients receiving a 2nd dose, was higher for the patients receiving 50% more RAI for the 2nd treatment (92.30%) compared to those whose 2nd dose was increased to 20% (66.67%). Therefore, a 50% increase in the RAI dose is the optimum approach in the recurrence of Graves' disease.
Questions about this event email: charles.intenzo@mail.tju.edu
Intenzo MD, C,
Repeat I-131 Therapy in Graves' Disease: What is the Optimal Approach?. Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL.
http://archive.rsna.org/2003/3102052.html
