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갑상선암 전이의 방사성요오드 치료

RAI Treatment of Distant Metastasis of Thyroid Cancer

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초록

For the distant metastasis of differentiated thyroid cancers, such as papillary thyroid carcinoma, follicular thyroid carcinoma, and Hürthle cell carcinoma, radioiodine therapy is one of the standard treatment methods after total thyroidectomy. Radioiodine is accumulated in thyroid cells and thyroid cancer cells through sodium iodide symporter which is located in the membrane of cells. This molecular target specific therapy renders a better prognosis and less adverse effects. Radioiodine 131I emits gamma ray for imaging and beta ray for treatment at the same time, we can monitor patients’ specific distribution of radioiodine, which let us know unexpected metastasis lesions or differentiated status of thyroid cancer cells. In this article, I reviewed practical points of view about radioiodine therapy for distant metastasis of thyroid cancers such as methods for administration of radioiodine, patients’ preparation before radioiodine treatment, follow up of patients, adverse effects, and radiation safety issues.

Abstract

For the distant metastasis of differentiated thyroid cancers, such as papillary thyroid carcinoma, follicular thyroid carcinoma, and Hürthle cell carcinoma, radioiodine therapy is one of the standard treatment methods after total thyroidectomy. Radioiodine is accumulated in thyroid cells and thyroid cancer cells through sodium iodide symporter which is located in the membrane of cells. This molecular target specific therapy renders a better prognosis and less adverse effects. Radioiodine 131I emits gamma ray for imaging and beta ray for treatment at the same time, we can monitor patients’ specific distribution of radioiodine, which let us know unexpected metastasis lesions or differentiated status of thyroid cancer cells. In this article, I reviewed practical points of view about radioiodine therapy for distant metastasis of thyroid cancers such as methods for administration of radioiodine, patients’ preparation before radioiodine treatment, follow up of patients, adverse effects, and radiation safety issues.

참고문헌 (6)

  1. Chung JK, "Chang-Soon Koh nuclear medicine" (2008), Korea Medical Book Publisher
  2. "National Comprehensive Cancer Network Clinical Practice Guidelines in OncologyTM. Thyroid Carcinoma. V.2", ~ (2012)
  3. Cooper DS, "Management guidelines for patients with thyroid nodules and differentiated thyroid cancer", Thyroid, 16(2), pp.109~142 (2006)
  4. 노지호, "갑상선암의 방사성요오드치료를 위한 저요오드식이 방법 차이에 따른 소변 중 요오드", 크레아티닌 비의 비교, 2006, pp.40(6), 322~326[DOI]
  5. 김원배, "갑상선결절 및 암 진료 권고안", Endocrinology and Metabolism, 22(3), pp.157~187 (2007), 대한내분비학회
  6. Chung JK, "Clinical significance of hepatic visualization on iodine-131 whole-body scan in patients with thyroid carcinoma", J Nucl Med, 38(8), pp.1191~1195 (1997)

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