Some Approaches to Treatment of Patients with Thyroid Nodular Diseases in the Semipalatinsk Region of Kazakhstan

It was determined by experts that in the region adjacent to the Semipalatinsk Nuclear Test Site thyroid nodular prevalence was significantly associated with radiation dose from nuclear weapons testing. The medical rehabilitation of patients is of special practical and scientific importance in this region. Some patients have contraindications for surgery and radioiodine or refuse them for various reasons. Percutaneous intranodular injection therapy by "Paoscle" (PIITP) was used for treatment of patients with benign thyroid nodular diseases. The study group included a total of 107 patients (mainly "pretoxic" and "compensated" nodules). Seventyfour patients received PIITP on an out-patient basis. Seventy-two of them were women and 2 men, mean age, 52.9±1.3 years; range 26 to 77 years. Thyroid ultrasound examination, fineneedle aspiration biopsy, thyroid function tests and cytopathology were performed in all patients to evaluate the effectiveness of treatment. The nodule volume reduction rate for patients with thyroid adenomas was 56% on average and 60.2% in the case of colloid nodules. The reduction rate of thyroid adenomas with necrotic and cystic degeneration was higher and reached 72%. The suggested method is indicated for cases of benign nodular thyroid diseases (cysts, adenomas, adenomas with necrotic and cystic degeneration, colloid nodules, polynodular goiter). We did not reveal any complications or thyroid test abnormalities after the treatment. A tendency to normalization of the blood serum thyroglobulin level and antibodies to thyroglobulin was documented. Analysis of the treatment results revealed that this approach is effective, inexpensive, safe, well tolerated and can be used on an outpatient basis