放射性療法可以治療兒童的葛瑞夫茲病


2003 年4月4 日.- 成人葛瑞夫茲病的放射性療法已行之多年,但是兒童則未曾使用。根據發表於4月號Pediatrics的一項研究結果,需要大於270 Gy的劑量使95%的兒童和青少年之甲狀腺脫落。目前仍需要更長的試驗,以確定這種方法的長期風險和優點。
  
  康涅狄格紐黑文的耶魯大學醫學院Scott A. Rivkees博士和Eugene A. Cornelius, MD博士表示,碘131 是兒童和成人葛瑞夫茲甲狀腺機能亢進一種有效的治療。但是兒童對於碘131劑量的治療反應是不明確的。
  
  作者比較31名葛瑞夫茲病兒童和青少年以三個不同碘131劑量治療的結果,年齡範圍從7到18歲。在一年之後,以100 Gy (110μCi/g)治療導致50%的受試者甲狀腺機能不足,以200 Gy (220μCi/g)治療導致70%的受試者甲狀腺機能不足,以300 Gy (330 μCi/g)則導致95%的受試者甲狀腺機能不足。
  
  作者表示,這項資料顯示,為了確保甲狀腺組織的燒蝕,需要大於270 Gy (300 .Ci/g) 的劑量,特別是當甲狀腺較大時。進一步的研究評估兒童葛瑞夫茲病具燒蝕力的碘131療法之長期風險,是否低於那些碘131或其他療法具燒蝕力以下的劑量。
  

Radioactive Therapy Treats Gra

By Laurie Barclay, MD
Medscape Medical News

April 4, 2003 — Radioactive therapy for Graves' disease is well established in adults, but not in children. A dose of greater than 270 Gy is necessary to ablate the thyroid in 95% of children and adolescents, according to the results of a dose-finding study published in the April issue of Pediatrics. Longer trials are needed to determine the long-term risks and benefits of this approach.

"Iodine-131 is an effective treatment for Graves' hyperthyroidism in children and adults," write Scott A. Rivkees, MD, and Eugene A. Cornelius, MD, PhD, from Yale University School of Medicine in New Haven, Connecticut. "Yet the responses to treatment as related to iodine-131 dose in children are not well-defined."

The authors compared the outcome of treatment with iodine-131 at three different doses in 31 children and adolescents with Graves' disease, ranging in age from 7 to 18 years. After one year, treatment resulted in hypothyroidism in 50% of subjects treated with 100 Gy (110 µCi/g), in 70% of subjects treated with 200 Gy (220 µCi/g), and in 95% of subjects treated with 300 Gy (330 µCi/g).

"These data show that to insure ablation of thyroid tissue doses, >270 Gy (300 µCi/g) is needed, especially when the thyroid is large," the authors write. "Further studies are indicated to assess if the long-term risks of ablative iodine-131 therapy for childhood Graves' disease are less than those associated with subablative doses of iodine-131 or exclusive medical therapy."

Pediatrics. 2003;111:745-749

Reviewed by Gary D. Vogin, MD

    
相關報導
家庭治療可能對嚴重兒童肥胖患者有效
2009/10/22 上午 09:31:00
常見的兒童中毒處置回顧
2009/3/13 下午 05:37:00
蔗糖可能對兒童止痛有幫助
2009/3/9 上午 09:47:00

上一頁
   1   2   3   4   5   6   7   8   9   10  




回上一頁