Hemodialyzovaný pacient s karcinomem štítné žlázy léčený 131I
Authors:
Pavel Širůček () 1; Lubomír Mrhač () 2; Martin Havel () 2; Gabriela Havlová () 2; Otakar Kraft () 1; Šárka Dočkalová () 2; Renata Olšanská () 3
Authors place of work:
Klinika nukleární medicíny, FN Ostrava, Lékařská fakulta Ostravské univerzity
1; Klinika nukleární medicíny FN Ostrava
2; Hemodialyzační centrum FN Ostrava
3
Published in the journal:
NuklMed 2012;1:48-52
Category:
Casuistry
Summary
For patients with differentiated thyroid cancer in end-stage renal failure who require dialysis, treatment with I-131 isotope may be essential. Diagnosis of cancer excludes these patients from the waiting list for kidney transplantation until the 3-5 year remission is reached. As patients with normal renal function eliminate I-131 from the body mainly by the kidneys, the effective half-life of I-131 in patients with renal failure is prolonged. Therefore, therapeutic dose administered should be reduced in order to reduce the radiation burden especially to the red bone marrow. We present a case report of a 48 year old man in end-stage renal failure treated with I-131 for papillary thyroid carcinoma. For this particular patient we reduced the therapeutic dose by 30 %. Hemodialysis was performed after administration of therapeutic doses of I-131 directly in the premises of nuclear medicine clinic. I-131 is dialyzable and after each dialysis residual radiation decreased by 33-67 %. Radiation exposure of hemodialysis center staff was minimal. Dialysis of patient treated with I-131 did not cause contamination of the dialysis unit.
Key words:
hemodialysis, thyroid cancer, treatment with I-131
Zdroje
1. Andres A, Tardín L, Santapau A et al. Treatment with (131)I of thyroid remnants in a patient with papillary thyroid carcinoma and end-stage chronic renal failure. Rev Esp Med Nucl 2010;29:32-5
2. Jiménez RG, Moreno AS, Gonzalez EN et al. Iodine-131 treatment of thyroid papillary carcinoma in patients undergoing dialysis for chronic renal failure: a dosimetric method. Thyroid 2001;11:1031-4
3. Mello AM, Isaacs R, Petersen J et al. Management of thyroid papillary carcinoma with radioiodine in a patient with end stage renal disease on hemodialysis, Clin Nucl Med 1994;19:776-81
4. Modarresifar H, Almodovar S, Bass WB et al. Radiation safety protocol for high dose 131I therapy of thyroid carcinoma in patients on hemodialysis for chronic renal failure. Health Phys 2007;92:45-9
5. Sinsakul M, Ali A., Radioactive 131I use in end-stage renal disease: nightmare or nuisance? Semin Dial 2004;17:53-6
6. Holst JP, Burman KD, Atkins F et al. Radioiodine therapy for thyroid cancer and hyperthyroidism in patients with end-stage renal disease on hemodialysis. Thyroid 2005;15:1321-31
7. Pahlka RB, Sonnad JR. The effects of dialysis on 131I kinetics and dosimetry in thyroid cancer patients a pharmacokinetic model. Health Phys 2006;91:227-37
8. Kaptein EM, Levenson H, Siegel ME et al. Radioiodine dosimetry in patients with end-stage renal disease receiving continuous ambulatory peritoneal dialysis therapy. J Clin Endocrinol Metab 2000;85:3058-64
Štítky
Nuclear medicine Radiodiagnostics RadiotherapyČlánok vyšiel v časopise
Nuclear Medicine
2012 Číslo 3
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