[Determination of factors affecting the therapeutic outcome of radioiodine therapy in patients with Graves' disease].
OBJECTIVE
Of this study was to determine whether success of radioiodine therapy (RIT) in Graves' disease depends on thyroid volume, function, thyroideal receptor antibodies (TRAK), thyreostasis, therapeutic dosage, 131I uptake, or effective half-life.


METHODS
78 patients received an average of 626 +/- 251 MBq of iodine-131 orally for thyroid ablation. 60 were assessed for successful therapy 3 months after RIT.


RESULTS
In patients showing hyperthyreosis or a TRAK value > 11 U/l at the beginning of RIT, a significantly lower therapeutic dosage and effective iodine half-life were found than in non-hyperthyreotic patients or patients with TRAK < or = 11 U/l. Patients with a thyroid volume < or = 25 ml showed a significantly lower 131I uptake, but a significantly higher relative uptake (131I uptake/ volume) than patients with a thyroid volume > 25 ml. All failures were treated thyreostatically during RIT and showed a significantly lower therapeutic iodine dosage and relative uptake, as well as a significantly higher thyroid volume than patients with a successful therapy. RIT caused a thyroid volume reduction of 44%, with therapy failures showing a significantly lower volume reduction. Patients who received a therapeutic dosage of < or = 250 Gy showed significantly worse results than did those who had received > 250 Gy. Only one case of therapy failure received a dosage > 250 Gy, while 50% of failures received dosages > 200 Gy but < 250 Gy. Multivariate analyses (MANOVA, factor analyses) showed thyreostasis as the decisive negative factor for a successful course of therapy.


CONCLUSIONS
Since most treatment failures occurred in patients under thyreostatic medication we recommend raising the target dosage to 250 Gy for these cases.
Sabri
O
O
Klinik für Nuklearmedizin der RWTH Aachen, Deutschland.
Schulz
G
G
Zimny
M
M
Schreckenberger
M
M
Zimny
D
D
Wagenknecht
G
G
Kaiser
H J
HJ
Dohmen
B M
BM
Bares
R
R
Büll
U
U
D000284:Administration, Oral; D013956:Antithyroid Agents / Q000627:therapeutic use; D005260:Female; D006111:Graves Disease / Q000097:blood / Q000188:drug therapy / Q000532:radiotherapy*; D006207:Half-Life; D006801:Humans; D007457:Iodine Radioisotopes / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011879:Radiotherapy Dosage; D013961:Thyroid Gland / Q000033:anatomy & histology / Q000503:physiopathology / Q000528:radiation effects*; D013974:Thyroxine / Q000097:blood; D013997:Time Factors; D017211:Treatment Failure; D016896:Treatment Outcome; D014284:Triiodothyronine / Q000097:blood
D013956:Antithyroid Agents; D007457:Iodine Radioisotopes; D014284:Triiodothyronine; D013974:Thyroxine
Bestimmung von Einflussgrössen für den Therapieerfolg der Radioiodtherapie bei Patienten mit Morbus Basedow.