Radioiodotherapeusis

Abstract

A total of 111 patients have been treated with radioiodine; 106 had thyrotoxicosis; three had non-toxic nodular goiter and two had malignant adenoma. Six of the thyrotoxic subjects received their treatment too recently for adequate consideration. In ninety-two of ninety-seven patients treated with I 131 a remission was produced and has persisted. Most of these patients became euthyroid within six months, an average of approximately three months. A total of 222 doses of radioiodine were given to ninety-seven patients; an average of 2.2 doses per patient. Thirty-five required only one dose; fourteen were given more than three doses. In the group experiencing remissions within six months, approximately 225 μc. per Gm. of thyroid tissue were administered. An average total of about 8 mc. was required for thyrotoxic patients with diffuse hyperplasia of the thyroid and those previously thyroidectomized; twenty-two individuals with toxic nodular goiter required larger total doses although somewhat smaller in proportion to the size of the thyroid gland. The goiter was reduced in size in all instances. Indeed, in all except one of the patients with diffuse hyperplasia the gland decreased to an estimated 25 Gm. or less; the one exception was an individual who declined to return for completion of therapy. In most of the patients with diffuse hyperplasia the thyroid became reduced to essentially normal or subnormal size before remission resulted. Three patients developed persistent myxedema. In sixteen others transient hypothyroidism resulted. Three individuals with thyrotoxicosis were treated with I 130 with excellent results. In two patients with malignant adenoma the cervical masses became impalpable. Three subjects with non-toxic nodular goiter experienced only slight reduction in the size of the goiters. No significant untoward effects from the radioiodine were manifested by non-thyroid tissues. One individual was pregnant at the time of her therapy, one had acute glomerular nephritis, one had chronic pyelonephritis, three had had acute hepatitis and several had congestive heart failure. An outline of our present plan of therapy and a discussion of many factors concerned with iodotherapeusis are given in the following paper.