科研之友
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摘要
Objective To validate the simplest approach to preparing patients with differentiated thyroid carcinoma (DTC) for 131I-administration (131I-A), minimizing the impact of hypothyroidism. Design Panel study. Patients Ninety patients with DTC were enrolled in the study. Sixty (Group A) underwent total thyroidectomy (TT); L-T4 was not administered in preparation for 131I-A planned for 3 weeks later. Thirty patients (Group B) with previous TT and 131I-A stopped L-T4 in preparation for clinical evaluation, including whole-body scanning (WBS)/radioiodine therapy during thyrotrophin (TSH) stimulation planned for 3 weeks (or more) later. Measurements Thyrotrophin was measured the day before TT for group A, during L-T4 for group B (baseline-time 1) and then every week until it reached =30 mIU/l (time 2). Quality of life (QoL) was evaluated by Billewicz index. Results At week 3, 100% of patients in group A and 56.6% of group B exceeded TSH %26gt; 30 mIU/l. In group B, the cut-off was achieved in four patients at the fourth week (TSH 38.6 +/- 8.7 mIU/l), in 3 at the fifth (53.2 +/- 3) and in 6 at the sixth (42.3 +/- 6.1). From time 1 to time 2, total QoL scores were less affected in group A (percentage decrease: 105%) than in group B (218%). At time 2, the total score was %26gt;+19 in group A in 46 patients and in 30 in group B. In group A, TSH levels in the higher tertile of QoL (61 +/- 6 mIU/l) were not different from those in the lower tertile (62.3 +/- 11.1)(P %26gt; 0.1); similar results were seen in group B (69.3 +/- 13.3 vs 62.9 +/- 13.1)(P %26gt; 0.1). There was a positive correlation between the time to obtain TSH = 30 mIU/l and total QoL scores. Conclusions Quality of life scores were not affected by thyrotrophin was measured the day before TT levels as absolute values. A longer time to obtain TSH = 30 mIU/l was positively correlated with worse scores of QoL. We suggest 3 weeks without therapy can be used as an easy schedule in patients who undergo TT for DTC.
- 出版日期2013-1
