Predictores de la respuesta a la terapia con yodo radiactivo en el hipertiroidismo: concepto de dosis ablativa: una experiencia de 23 años en un único centro con 914 pacientes

IF 1.2 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Revista Espanola De Medicina Nuclear E Imagen Molecular Pub Date : 2026-07-01 Epub Date: 2026-01-27 DOI:10.1016/j.remn.2025.500264

N. Pantic, J. Petrovic, S. Odalovic, D. Sobic Saranovic, M. Kotur, L. Grujicic, J. Zivanovic, J. Pantovic, I. Grozdic Milojevic, V. Artiko, B. Radovic

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引用次数: 0

Abstract

Objective

The three treatment modalities for patients with hyperthyroidism are antithyroid drugs (ATDs), surgery, and radioactive iodine (RAI) therapy. The study aims to determine the predictors of a response to RAI in patients with hyperthyroidism.

Materials and methods

We retrospectively assessed 914 patients who received RAI for the treatment of hyperthyroidism between January 2000 and December 2023, with a follow-up of at least 6 months after the first dose.

Results

Hypothyroidism was ultimately achieved in 62.9% of the patients. Multiple variables are possible predictors in univariable logistic regression analysis. However, only shorter duration of ATD therapy (odds ratio 0.996; 95% confidence interval [CI], 0.093-0.999; P=.003, multivariable logistic regression analysis) and a diagnosis of Graves’ disease (GD) (odds ratio, 1.803; 95% confidence interval [CI], 1.042-3.141; P=.035, multivariable logistic regression analysis) are the independent predictors of post-treatment hypothyroidism, with decreasing age also being a late-response independent predictor of hypothyroidism 24 months after the treatment (odds ratio 0.983; 95% confidence interval [CI], 0.968-0.998; P=.028, multivariable logistic regression analysis). The median time to hypothyroidism was 10.0 ± 0.7 months (Kaplan-Meier method), with a statistically significant difference in hypothyroidism-free survival (HFS) between patients with GD on one side and solitary toxic adenoma (STA) and toxic multinodular goiter (TMG) on the other (P<.001, log-rank test).

Conclusions

GD and a shorter duration of previous ATD therapy are independent predictors of post-therapeutic hypothyroidism in patients treated for hyperthyroidism with RAI, with younger age also being an independent predictor of a late response.

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放射性碘治疗甲状腺机能亢进反应的预测因素：消融剂量概念：在914名患者的单一中心23年经验

目的抗甲状腺药物（ATDs）、手术治疗和放射性碘（RAI）治疗是甲状腺功能亢进患者的三种治疗方式。该研究旨在确定甲状腺功能亢进患者对RAI反应的预测因素。材料和方法回顾性评估2000年1月至2023年12月期间接受RAI治疗甲状腺功能亢进的914例患者，首次给药后随访至少6个月。结果62.9%的患者最终实现甲状腺功能减退。在单变量logistic回归分析中，多变量是可能的预测因子。然而，只有较短的ATD治疗时间（优势比0.996；95%可信区间[CI]， 0.093-0.999； P= 0.003，多变量logistic回归分析）和诊断为Graves病（GD）(优势比1.803；95%可信区间[CI]， 1.042-3.141；P= 0.035，多变量logistic回归分析)是治疗后甲状腺功能减退的独立预测因子，年龄下降也是治疗后24个月甲状腺功能减退的晚期反应独立预测因子（优势比0.983；95%可信区间[CI]， 0.968 ~ 0.998； P= 0.028，多变量logistic回归分析）。发生甲状腺功能减退的中位时间为10.0±0.7个月（Kaplan-Meier法），单侧GD患者与单侧中毒性腺瘤（STA）、中毒性多结节性甲状腺肿（TMG）患者无甲状腺功能减退生存期（HFS）差异有统计学意义（P< 0.001， log-rank检验）。结论sgd和既往ATD治疗时间较短是RAI治疗甲状腺功能亢进患者治疗后甲状腺功能减退的独立预测因素，年龄较小也是延迟反应的独立预测因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Revista Espanola De Medicina Nuclear E Imagen Molecular RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

1.10

自引率

16.70%

发文量

审稿时长

24 days

期刊介绍： The Revista Española de Medicina Nuclear e Imagen Molecular (Spanish Journal of Nuclear Medicine and Molecular Imaging), was founded in 1982, and is the official journal of the Spanish Society of Nuclear Medicine and Molecular Imaging, which has more than 700 members. The Journal, which publishes 6 regular issues per year, has the promotion of research and continuing education in all fields of Nuclear Medicine as its main aim. For this, its principal sections are Originals, Clinical Notes, Images of Interest, and Special Collaboration articles.