Efficiency evaluation of treatment of different etiologies toxic goiter with radioactive iodine

Work aim: to evaluate the efficiency of treatment of different etiologies toxic goiter with radioactive iodine. Tasks: 1. To determine the dependence of the treatment outcome on thyrostatics medical use duration before radioactive iodine therapy and antithyroid peroxidase antibodies (anti-TPO) concentration. 2. To assess the dependence of treatment effectiveness on radioiodine dose, absorbed dose of radioactive iodine and effective half-life. 3. To determine the effectiveness of treatment dependent on the mass of the thyroid gland. 4. To assess the results of the treatment with radioactive iodine. Retrospective medical records study of patients with toxic goiter, who undergone 131I therapy at LSMUL KK was performed during the period 2010 – 2013. The treatment was effective if developed into hypothyroidism or euthyroidism, ineffective – hyperthyroidism. The study included 236 patients. Patients divided into 3 groups according to the origin of thyrotoxicosis: Group I – Graves' disease, II – toxic adenoma, III – toxic multinodular goiter. Group I consisted of 101 patients, II – 63, III – 72. In assessing the effectiveness of treatment and duration of thyrostatics use, radioactive iodine dose, effective half-life had no statistically significant dependence. The effectiveness of Graves’ disease treatment has dependence on anti-TPO levels. The weight of the thyroid gland, when the treatment was effective: I – 23.64 g, II – 10.62 g, III – 25.38 g, when ineffective: I – 31.41 g, III –30.29 g The amount of absorbed dose when the treatment was effective: I – 154.28 Gy, II – 187.66 Gy, III – 164.16 Gy, when ineffective: I – 151.04 Gy, III - 148.15 Gy. The clinical outcomes of group I: 25.74% of patients were euthyroid, 45.55% had hypothyroidism, 28.71% had hyperthyrosis. Group II: 93.65% of patients were euthyroid, 6.35% had hypothyroidism. Group III: 50% of patients were euthyroid, 26.39% had hypothyroidism, 23.61% had hyperthyrosis. When thyrotoxicosis remained second therapy was applied for 50% of patients. 21.7% of patients were euthyroid, 78.3% had hypothyroidism. Conclusions: 1. The results of the treatment depend on the concentration of anti-TPO while do not depend on duration of thyrostatics use before radioactive iodine therapy. 2. The effectiveness of the treatment has dependence on absorbed dose, but not on the dose of radioactive iodine and the effective half-life. 3. There is a dependence on the effectiveness of treatment of thyroid weight. 4. The treatment was effective in Group I for 71.29%, II - 100%, III – 76.39%. Recommendations: 1. In case of increased anti-TPO concentration, it is recommended higher absorbed dose. 2. The presence of thyroid weight more than 31 grams, it is recommended higher absorbed dose