Fard Esfahani A, Dabbagh Kakhki Vr, Eftekhari M, Zarpak B, Saghari M, Fallahi Sijani B,
Volume 61, Issue 4 (15 2003)
Abstract
Radioiodine therapy is the safest, simplest, least expensive and most effective method for treatment of Graves' disease. Due to difficulties in previous methods for dose determination, fixed dose method of 1-131 is now considered the best practical method for 1-131 therapy in Graves' disease, but there is no consensus on the dose. We compared two routinely recommended fixed doses of 5 and 10 mCi for this purpose.
Materials and Methods In this clinical trial, 59 patients with Graves' disease referred for radioiodine therapy were randomized into two groups, one group was treated with 5 mCi of 1-131 and the other with 10 mCi. All patients were followed for two years, with 6-month intervals.
Results: Totally, among 59 patients treated with 1-131, 20 (33.9%) patients became euthyroid and 19(32.2%) became hypothyroid, while failed therapy (no response or relapse) was noticed in 20 patients (33.9%). In the group treated by 5 mCi (33 patients), 10(30.3%) were euthyroid, 6(18.2%) were hypothyroid (overall cure of ^8.5%), while 17(51.5%) remained hyperthyroid by the end of the follow-up period. From the 26 patients treated with 10 mCi, the euthyroid and hypothyroid states were observed in 10(38.5%) and 13(50%)patients, respectively (overall cure rate of 88.5%), and hyperthyroid state in 3(11.5%). No relationship was noted between the outcome and age, sex, size of the thyroid gland and thyroid uptake, but the relationship between the disease outcome and the amount of administered radioiodine was significant (P<0.003). Although the incidence rate of early hypothyroidism (by the end of 2 years) in the group treated with 5 mCi is less than those treated with 10 mCi, the incidence of failed therapy is higher in the former group. In addition, it is known that long-term hypothyroidism prevalence is not significantly different by using different doses of I-131. On the other hand, if the initial dose is so little to cure, cost and time for perfect treatment, number of office visits and morbidity due to untreated hyperthyroidism are markedly increased.
Conclusion: Regarding lower rate of failed therapy with 10 mCi, and as there is no significant difference in late hypothyroidism between low doses and high doses of I-131, we concluded that 10 mci is the optimal fixed dose for treatment of Graves' disease.
Fard Esfahani A, Eftekhari M, Aliyari Zenooz N, Saghari M, Beygi D,
Volume 62, Issue 1 (12 2004)
Abstract
Background: The purpose of this study was to evaluate the effect of treatment with radioactive iodine on the function of gonads in males and females with follicular and papillary thyroid carcinoma.
Materials and Methods: Consenting patients in the reproductive age were grouped according to the cumulative dose of received radioiodine and followed for at least 12 months. For all men, serum levels of FSH, LH, and testosterone were measured some (53 cases) were also studied by semen analysis. For women, tests for serum levels of LH, FSH, estrogen, and progesterone were performed.
Results: Overall, 246 patients (159 females, 87 males) were studied. In 87.4% of men, there was an increase in serum FSH level after radioiodine therapy, in 20.7% of whom the level remained high during follow-up period. The average serum level of FSH after each course of treatment was significantly higher than the level before treatment (p<0.01), and there was a meaningful correlation with the cumulative dose of received iodine (p<0.001). Reduced number of sperms was shown in 35.8% of male patients, among whom 73.7% also showed reduced motility. In 36.8% of the patients with reduced sperm number (13.2% of the total), this finding was persistent during the follow-up period. Increased level of FSH was correlated with reduced sperm counts in all doses (p
