Cancer incidence and mortality following treatment of hyperthyroidism with radioactive iodine.
Cancer incidence and mortality following treatment of hyperthyroidism with radioactive iodine.
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DOI：
10.1097/med.0000000000000561
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发表时间：
2020-10
期刊：
影响因子：
--
通讯作者：
Papaleontiou M
中科院分区：
文献类型：
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作者：
Evron JM;Esfandiari NH;Papaleontiou M
甲状腺功能亢进症是临床上常见的问题。放射性碘是过去 80 年来采用的治疗方式之一。先前的研究对于放射性碘是否与随后发生恶性肿瘤和相关死亡率的风险增加有关存在矛盾。本文回顾了有关该主题的最新出版物。最近的两项研究对现有文献做出了有意义的贡献；然而，数据仍然不一致。第一项研究使用 Clalit 健康服务数据库进行，评估了放射性碘治疗后实体瘤的发病率，发现与实体瘤恶性肿瘤风险增加没有关联。第二项是对甲状腺毒症合作治疗随访研究的最新分析，得出的结论是，使用一种估计器官特异性辐射暴露的新方法，实体瘤死亡风险呈剂量依赖性增加。对于甲状腺功能亢进症患者，放射性碘是一种流行且有效的治疗选择。先前的研究对于放射性碘与随后的癌症发病率和死亡率之间的潜在关系得出了相互矛盾的结论。我们回顾了最近的出版物，这些出版物增加了我们对这一重要临床问题的理解。
Hyperthyroidism is a commonly encountered clinical issue. Radioactive iodine is one of the treatment modalities employed over the last 80 years. Prior studies are conflicting as to whether radioactive iodine is associated with an increased risk of subsequent malignancy and associated mortality. This article reviews recent publications on this subject. Two recent studies make meaningful contributions to the existing literature; however, data remain inconsistent. The first, conducted using the Clalit Health Services database, evaluated solid tumor incidence after radioactive iodine and found no association with increased risk of solid tumor malignancy. The second, which is an updated analysis of the Cooperative Thyrotoxicosis Therapy Follow-up Study, concluded that there is a dose-dependent increased risk of solid tumor mortality using a novel method of estimating organ-specific radiation exposure. In patients with hyperthyroidism, radioactive iodine is a popular and effective treatment option. Prior studies reach conflicting conclusions on the potential relationship between radioactive iodine and both subsequent cancer incidence and mortality. We review recent publications that add to our understanding of this important clinical question.