title: The role of radioiodine therapy in benign nodular goitre.
abstract: For treatment of benign nodular goitre the choice usually stands between surgery and (131)I therapy. (131)I therapy, used for 30 years for this condition, leads to a goitre volume reduction of 35-50% within 1-2 years. However, this treatment has limited efficacy if the thyroid (131)I uptake is low or if the goitre is large. Recombinant human TSH (rhTSH)-stimulated (131)I therapy significantly improves goitre reduction, as compared with conventional (131)I therapy without pre-stimulation, and adverse effects are few with rhTSH doses of 0.1 mg or lower. RhTSH-stimulated (131)I therapy reduces the need for additional therapy due to insufficient goitre reduction, but the price is a higher rate of hypothyroidism. Another approach with rhTSH-stimulation is to reduce the administered (131)I activity by a factor that equals the increase in the thyroid (131)I uptake. Using this approach, radiation exposure is considerably reduced while the goitre reduction is similar to that obtained with conventional (131)I therapy.
authors.affiliation: Department of Endocrinology, Odense University Hospital, DK-5000 Odense C, Denmark. Electronic address: steen.bonnema@dadlnet.dk.
authors.forename: Steen Joop
authors.initials: SJ
authors.lastname: Bonnema
authors.affiliation: Department of ENT Head & Neck Surgery, Hospital Lillebaelt, DK-7000 Vejle, Denmark. Electronic address: soeren.fast@rsyd.dk.
authors.forename: Søren
authors.initials: S
authors.lastname: Fast
authors.affiliation: Department of Endocrinology, Odense University Hospital, DK-5000 Odense C, Denmark. Electronic address: laszlo.hegedus@rsyd.dk.
authors.forename: Laszlo
authors.initials: L
authors.lastname: Hegedüs
mesh_terms: D002755:Choice Behavior; D006044:Goiter, Nodular / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D009929:Organ Size; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods; D011994:Recombinant Proteins / Q000627:therapeutic use; D013965:Thyroidectomy / Q000706:statistics & numerical data; D013972:Thyrotropin / Q000627:therapeutic use
chemical_list: D007457:Iodine Radioisotopes; D011994:Recombinant Proteins; D013972:Thyrotropin
keywords: nodular goitre; radioiodine; recombinant human thyrotropin; thyroid diseases