131I therapy and Graves' disease in a long term observation: euthyroidism is a suitable goal. Our experience.
OBJECTIVE
The aim of the study was to verify early and definitive outcome of radioiodine therapy in patients with Graves' disease, administering 131I calculated dose to pursue euthyroidism.


METHODS
We retrospectively analyzed 639 patients affected by Graves' disease and treated by one or more 131I calculated doses. Results dose by dose are reported. As to the first administration, outcome is related to parameters used to calculate dose and to patients' available features. Failures and hypothyroidism onset are evaluated.


RESULTS
A mean dose of 10 mCi shows great effectiveness: 75% of patients were cured after one administration, 88% after two. Of the failures, 84.1% occurred in a mean time of 0.34±0.23 years and were more frequent for larger glands, accelerated intra-gland radioiodine turnover, ophtalmopathy, administration of antithyroid drugs until 131I therapy. Of hypothyroid patients, 39.8% were diagnosed within the first year. After a sharp initial rise, hypothyroidism occurred at a slower rate, with estimated yearly increases of 3.8% until 10 years and of 1.8% later. In still followed up patients, euthyroidism was observed in about half the population after 10 years and in a third after 25 years.


CONCLUSIONS
131I can be the first line treatment for Graves' disease in small-medium thyroids. Calculated doses can achieve a high amount of long term euthyroid patients. Similar results could be expected by fixed doses of 10 mCi.
Department of Internal Medicine and Medical Specialities, Unit of Nuclear Medicine, University of Rome "Sapienza", Italy.
T
T
Montesano
Department of Internal Medicine and Medical Specialities, Unit of Nuclear Medicine, University of Rome "Sapienza", Italy.
M
M
Toteda
Department of Internal Medicine and Medical Specialities, Unit of Nuclear Medicine, University of Rome "Sapienza", Italy.
R
R
D'Apollo
Department of Internal Medicine and Medical Specialities, Unit of Nuclear Medicine, University of Rome "Sapienza", Italy.
A D
AD
Di Nicola
Department of Internal Medicine and Medical Specialities, Unit of Nuclear Medicine, University of Rome "Sapienza", Italy.
G
G
Acqualagna
Department of Internal Medicine and Medical Specialities, Unit of Nuclear Medicine, University of Rome "Sapienza", Italy.
M
M
Ciancamerla
Department of Internal Medicine and Medical Specialities, Unit of Nuclear Medicine, University of Rome "Sapienza", Italy.
F
F
Ticconi
Department of Internal Medicine and Medical Specialities, Unit of Nuclear Medicine, University of Rome "Sapienza", Italy.
F
F
Ugolini
Department of Internal Medicine and Medical Specialities, Unit of Nuclear Medicine, University of Rome "Sapienza", Italy.
M
M
Filesi
Department of Internal Medicine and Medical Specialities, Unit of Nuclear Medicine, University of Rome "Sapienza", Italy.
G
G
Ronga
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006111:Graves Disease / Q000532:radiotherapy*; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult
D007457:Iodine Radioisotopes