• Title/Summary/Keyword: 1-131 therapy

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A Clinical Review of Radioactive Iodine-131 Therapy in Differentiated Thyroid Carcinoma (갑상선(甲狀線) 분화암(分化癌)의 방사성 요드-131 치료(治療)에 대한 임상적(臨庶的) 고찰(考察))

  • Park Yoon-Kyu;Lee Dae-Young;Chon Seong-Eun;Oh Sung-Soo;Chung Eul-Sam
    • Korean Journal of Head & Neck Oncology
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    • v.12 no.1
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    • pp.32-42
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    • 1996
  • This study was desinged to evaluate the effect of radioactive iodine-131 therapy in differentiated thyroid carcinoma treated at the Presbyterian Medical Center, Chonju during the 20-year period from 1975 to 1994. The authors reviewed 246 patients who received radioactive iodine-131. An analysis of the therapeutic response and survival rates of the 246 patients has been carried out. The male to female ratio was 1 : 3.6. The peak incidence was in the 4th and 6th decades. The histologic findings in the 246 patients were papillary adenocarcinoma in 200 cases, follicular adenocarcinoma in 29 cases, mixed type in 14 cases, and others in 3 cases. Combined treatment modalities of 246 patients consisted of sugery and radioiodine in 222 cases, surgery with radioiodine and external irradiation in 11 cases, and surgery with radioiodine, external irradiation and chemotherapy in 5 cases. 42 of the 246 cases showed recurrence and the commonest type of combined treatment for recurrent case was surgery followed by radioiodine-131. The highest accumulated total dosage of radioiodine-131 was 480mCi in that case femoral metastasis was noticed. The most common locoregional metastatic site was ipsilateral cervical node, and neighbouring muscle, vessel, trachea, recurrent layngeal nerve, in order of frequency. The determinate 10-year survival rate was 91.8% in the group receiving surgery followed by radioiodine-13l and 71.4% in patients receiving surgery, radioiodine-13l with XRT. The determinate 10-year survival rate was better for patients under 40 years of age who received radioiodine as compared to patients over 40 year of age(85.7% vs. 33.3%). The most usual primary therapeutic dosage in the group of cervical lesion was 90$\sim$120mCi after surgery.

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Acute Myelogenous Leukemia Developed after Radioactive Iodine Therapy and Palliative Radiation Therapy in Metastatic Papillary Thyroid Cancer (갑상선 유두암환자에서 방사성 옥소 치료와 고식적 방사선 치료 후 발생한 급성 골수성 백혈병)

  • Ko, Tae-Young;Kwag, Jae-Sik;Oh, Kyung-Suk;Lee, Seung-Bai;Chung, Byung-Sun;Kim, Eun-Sil;Kim, Chong-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.5
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    • pp.436-442
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    • 1998
  • Radioactive iodine treatment has been widely used for nearly 50 years in the treatment of thyroid cancer to ablate residual thyroid tissue after thyroidectomy and to treat metastatic disease. Leukemia is a rare complication associated with the radioactive iodine therapy. The occurrence of leukemia is known to be related to the cumulative dosage of I-131 more than 37 GBq (1 Ci) and also associated with the intervals of less than 12 months between the repeated doses. We report a case of a 52 year-old female patient with papillary cancer of thyroid who developed acute myelogenous leukemia after the total 20.4 GBq (550 mCi) of I-131 therapy over 3.2 years and palliative radiation therapy (3000 cGy) due to multiple bone metastasis of papillary cancer.

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Review of Radionuclide Treatment for Neuroendocrine Tumors (신경내분비종양의 방사성핵종 치료)

  • Jeong, Hwan-Jeong
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.2
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    • pp.90-95
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    • 2006
  • Neuroendocrine tumors (NETs) consist of a heterogeneous group of tumors that are able to uptake neuroamine and/or specific receptors, such as somatostatin receptors, which can play important roles of the localization and treatment of these tumors. When considering therapy with radionuclides, the best radioligand should be carefully investigated. $^{131}I$-MIBG and beta-particle emitter labeled somatostatin analogs are well established radionuclide therapy modalities for NETs. $^{111}In,\;^{90}Y\;and\;^{177}Lu$ radiolabeled somatostatin analogues have been used for treatment of NETs. Further, radionuclide therapy modalities, for example, radioimmunotherapy, radiolabeled peptides such as minigastrin are currently under development and in different phases of clinical investigation. for all radionuclides used for therapy, long-term and survival statistics are not yet available and only partial tumour responses have been obtained using $^{131}I$-MIBG and $^{111}In$-octreotide. Experimental results using $^{90}Y$-DOTA-lanreotide as well as $^{90}Y-DOTA-D-Phe1-Tyr^3-octreotide$ and/or $^{177}Lu-DOTA-Tyr^3-octreotate$ have indicated the possible clinical potential of radionuclides receptor-targeted radiotherapy it may be hoped that the efficacy of radionuclide therapy will be improved by co-administration of chemotherapeutic drugs whose antitumoral properties may be synergistic with that of irradiation.

Iodine-131 S values for use in organ dose estimation of Korean patients in radioiodine therapy

  • Yeom, Yeon Soo;Shin, Bangho;Choi, Chansoo;Han, Haegin;Kim, Chan Hyeong
    • Nuclear Engineering and Technology
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    • v.54 no.2
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    • pp.689-700
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    • 2022
  • In the present study, iodine-131 S values (rT ← thyroid) were calculated for 30 target organs and tissues using the most recently developed Korean reference computational phantoms. The calculated S values were then compared with those of the International Commission on Radiological Protection (ICRP) reference computational phantoms to investigate the dosimetric impact of the Korean S values against those of the ICRP reference phantoms. The results showed significant differences in the S values due to the different anatomical/morphological characteristics between the Korean and ICRP reference phantoms. Most target organs/tissues showed that the S values of the Korean reference phantoms are lower than those of the ICRP reference phantoms, by up to about 4 times (male spleen and female thymus). Exceptionally, three target organs/tissues (gonads, thyroid, and extrathoracic region) showed that the S values of the Korean reference phantoms are greater, by 1.5-3.7 times. We expect that the S values calculated in the present study will be beneficially used to estimate organ/tissue doses of Korean patients under radioiodine therapy.

Comparison of Diagnostic and Post-therapy Radioiodine Scan in Well-Differentiated Thyroid Cancer and the Clinical Outcome (갑상선암 환자에서 방사성옥소 진단스캔과 치료 후 스캔의 비교 및 임상경과)

  • Lee, Seok-Mo;Bae, Sang-Kyun;Yum, Ha-Yong
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.1
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    • pp.22-29
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    • 2000
  • Purpose: We compared the first postoperative diagnostic and post-therapy scans of patients who received therapeutic doses of I-131, to investigate the difference in clinical outcomes between patients with concordant findings of diagnostic and post-therapy scans and patients with discrepant (more lesions in post-therapy scan) findings. Materials and Methods: The first postoperative diagnostic and post-therapy radioiodine scans of one hundred forty three patients with well differentiated thyroid carcinoma were reviewed. Diagnostic scans were obtained following ingestion of 185 MBq of I-131 and post-therapy scans were obtained after therapeutic dose of $3.7{\sim}9.3$ GBq of I-131. Successful ablation was defined as no radioiodine uptake on diagnostic radioiodine scan and normal range of serum thyroglobulin level (<10 ng/ml) during serum TSH elevation. Results: Discrepant scan findings were noted in 25 (17.5%) patients. Twenty-two patients (15.4%) showed more lesions in post-therapy scan and 3 patients (2.1%) showed stunning effect. Nine (64.3%) of 14 patients with distant metastasis revealed metastatic lesion(s) only on post-therapy scan. Stunning effect was considered as sublethal damage in 1 patient and treatment by a diagnostic dose in 2 patients. Ablation was achieved in 52.4% (75/143) of all patients. Ablation rate and mean cumulative radioiodine dose were not different statistically between concordant and discrepant groups. Conclusion: There were 17.5% difference between diagnostic and post-therapy scan findings when using 185 MBq of I-131 as a diagnostic dose. However, 64.3% of distant metastases were revealed only on post-therapy scan. Ablation rate and mean cumulative radioiodine dose were not different statistically between concordant and discrepant groups. The stunning effect was considered as not only sublethal damage but also treatment by a small diagnostic dose of radioiodine.

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A Study on the Effective Half-life after the High Dose Radioactive Iodine (131I) Therapy for Thyroid Cancer Patients (갑상선암 환자에서 고용량 방사성요오드 치료 후 유효반감기에 대한 연구)

  • Kim, Seongcheol;Gwon, DaYeong;Kim, Yongmin
    • Journal of the Korean Society of Radiology
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    • v.11 no.7
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    • pp.597-603
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    • 2017
  • High-dose $^{131}I$ therapy has been generally carried out to remove remaining thyroid tissue or to cure metastasize lesion of patients who received full thyroidectomy due to differentiated thyroid cancers. In case high-dose $^{131}I$ therapy is carried out for a patient, the patient should be hospitalized being isolated for a certain period in order to restrict the amount of exposure to radiation of people at large from the patient within the limit of a level of radiation. Effective half-life is an important value to calculate how family members are exposed to radiation from a patient or to decide the period of isolation of the patient from the family members. Therefore, in this study we calculated the effective decay constant, effective half-life and period of isolation of high-dose $^{131}I$ therapy patient using NM670 SPECT/CT. As a result of carrying out this study, the effective half-life of high-dose $^{131}I$ therapy patients was derived and the time to reach the discharge level of 1.2 GBq was confirmed. When they were compared with each other in each of curative doses, the effective half-life did not have significant difference, but the time when the level of radiation remaining in the interior of the body to reach the criteria of isolation and discharge showed significant difference and it could be confirmed that the higher the curative dose the longer the period of isolation becomes. When the effective half-lives in each type of preparation were compared with each other, they did not show significant difference. However, When the times to reach the level of radiation that is the criteria of isolation and discharge in each type of preparations, they showed significant difference. The cause of the shortening of the isolation period for rhTSH patients group is decided to be low curative dose. Accordingly, if the current national health insurance (the insurance is applied to using of rhTSH in 3.7 GBq or lower) is maintained, while discerning them in each of types of preparation, we would be able to discharge patients at the time earlier than the current period of isolation (2 nights and 3 days).

Comparison of I-131 Scintigraphy, T1-201 Scintigraphy, and Serum Thyroglobulin in the Postoperative Follow-Up of Differentiated Thyroid Cancer (분화된 갑상선암의 수술후 경과관찰에서 I-131 스캔, T1-201 스캔 및 혈청 갑상선 글로불린 농도의 비교)

  • Lee, Hyun-Kyung;Song, Jae-Soon;Shinn, Joon-Jae;You, Kye-Hwa;Cha, Wang-Ki;Kim, Eun-Sil;Kim, Chong-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.31 no.3
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    • pp.346-355
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    • 1997
  • To evaluate the utility of I-131, T1-201 scintigraphy, and serum thyroglobulin(Tg) in the follow-up of differentiated thyroid cancer, we compared retrospectively the data from 33 patients who underwent total or subtotal thyroidectomy. I-131 scintigraphy was performed after optimal endogenous TSH stimulation ($TSH>50{\mu}U/ml$). Total 41 cases of I-131 and T1-201 scintigraphy pairs were examined. Concomitant serum thyroglobulin levels were measured for 41 pairs of scan. Tg-off levels(that measured after discontinuation of the thyroid hormone) higher than 40ng/m1 were considered positive, and Tg-on levels(that measured during the thyroid hormone replacement) higher than 5ng/ml were considered positive. The concordance rates between I-131 therapeutic scintigraphy and T1-201 scintigraphy was 48% in the 38 case of total scan pairs(59% in the 17 cases of postoperative preablation group, and 38% in the 21 cases of postoperative postablation group). Of 17 studies before the I-131 ablation therapy(preablation group), 7 showed positive I-131 therapeutic scintigraphy despite of negative T1-201 scintigraphy. Among patients with negative I-131 therapeutic scintigraphy, no patients had abnormal T1-201 uptake. However, of 21 studies which were done after radioiodine therapy(postablation group) 6 had abnormal uptake on T1-201 scintigraphy which were not seen on I-131 therapeutic scintigraphy, and Tg-off levels also elevated in this 4 of 6 cases. As a result, I-131 therapeutic scintigraphy showed highest positive rate at postoperative preablation follow-up study in differentiated thyroid cancer patients. T1-201 scintigraphy may be useful in postablation studies, and the use of the combined modalities(T1-201 and Tg levels) provides a higher diagnostic yield.

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The Study and Measurement of Three Dimensional Spatial Dose Rate from Radioiodine Therapy (고용량 옥소 치료 시 3차원적 공간선량률 측정 및 연구)

  • Chang, Boseok
    • Journal of the Korean Society of Radiology
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    • v.7 no.3
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    • pp.251-257
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    • 2013
  • Spatial dose rates of high dose $^{131}I$ therapy patients were Measured Three dimensional (X, Y, Z) distributions. I have constructed geometrical an aluminum support structure for spatial dose meters placed in 5 different heights, 8 different azimuthal angles, 6 different time interval and distance 100 cm from High dose$^{131}I$ therapy patients. when the height of vertical plane Spatial dose distribution is 100 cm, the Spatial dose rates is max and the error range is low. the vertical plane Spatial dose rates was found to be 71.85 ${\mu}Sv/h$ on the average at a distance of 100 cm, height 100 cm, from the patients 24 hours after $^{131}I$ oral administration. I divided 12 patients into two groups. I have analysed group A (drinking 5 L water) and group B (drinking 3 L water) in order to measure decrease spatial dose rates. I have found the spatial distributions of patient dose rates is $44.9{\pm}7.2$ ${\mu}Sv/h$ in group A and $100.3{\pm}8.1$ ${\mu}Sv/h$ in group B by 24 after $^{131}I$ oral administration. the reduction factor was found to be approximately 54 % through drinking 5 L water during 24 hours.

The Clinical Study for Peripheral Facial Paralysis Treated with Herbal Stream Therapy (훈증요법을 병행한 말초성 안면신경마비 환자에 대한 임상적 고찰)

  • Park, Soo-Yeon;Kim, Ji-Soo;Jeong, Min-Young;Kim, Jong-Han;Choi, Jeong-Hwa
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.27 no.4
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    • pp.131-140
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    • 2014
  • Objective : This study was performed to investigate the effect of herbal steam therapy on peripheral facial paralysis. Method : 33 patients with peripheral facial paralysis were treated with Korean Medicine therapy including herbal steam therapy. We evaluated the effect of herbal steam therapy by Yanagihara grading system and satisfaction measurement. Results : 1. 33 patients were treated with korean medicine therapy and $27.85{\pm}16.44$ times of herbal steam therapy. 2. After treatment, Y-system score was significantly increased(p-value<0.001) from $18.45{\pm}6.5196$ to $35.42{\pm}5.2501$. 3. 87.88% of patients was satisfied with herbal steam therapy. Conclusions : Herbal stream therapy seem to be effective to improve symptoms of peripheral facial paralysis. Further studies will be needed to identify the beneficial of herbal steam therapy on peripheral facial paralysis.

The Study of Radiation Exposed dose According to 131I Radiation Isotope Therapy (131I 방사성 동위원소 치료에 따른 피폭 선량 연구)

  • Chang, Boseok;Yu, Seung-Man
    • Journal of the Korean Society of Radiology
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    • v.13 no.4
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    • pp.653-659
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    • 2019
  • The purpose of this study is to measure the (air dose rate of radiation dose) the discharged patient who was administrated high dose $^{131}I$ treatment, and to predict exposure radiation dose in public person. The dosimetric evaluation was performed according to the distance and angle using three copper rings in 30 patients who were treated with over 200mCi high dose Iodine therapy. The two observer were measured using a GM surverymeter with 8 point azimuth angle and three difference distance 50, 100, 150cm for precise radion dose measurement. We set up three predictive simulations to calculate the exposure dose based on this data. The most highest radiation dose rate was showed measuring angle $0^{\circ}$ at the height of 1m. The each distance average dose rate was used the azimuth angle average value of radiation dose rate. The maximum values of the external radiation dose rate depending on the distance were $214{\pm}16.5$, $59{\pm}9.1$ and $38{\pm}5.8{\mu}Sv/h$ at 50, 100, 150cm, respectively. If high dose Iodine treatment patient moves 5 hours using public transportation, an unspecified person in a side seat at 50cm is exposed 1.14 mSv radiation dose. A person who cares for 4days at a distance of 1 meter from a patient wearing a urine bag receives a maximum radiation dose of 6.5mSv. The maximum dose of radiation that a guardian can receive is 1.08mSv at a distance of 1.5m for 7days. The annual radiation dose limit is exceeded in a short time when applied the our developed radiation dose predictive modeling on the general public person who was around the patients with Iodine therapy. This study can be helpful in suggesting a reasonable guideline of the general public person protection system after discharge of high dose Iodine administered patients.