-
Categories
-
Pharmaceutical Intermediates
-
Active Pharmaceutical Ingredients
-
Food Additives
- Industrial Coatings
- Agrochemicals
- Dyes and Pigments
- Surfactant
- Flavors and Fragrances
- Chemical Reagents
- Catalyst and Auxiliary
- Natural Products
- Inorganic Chemistry
-
Organic Chemistry
-
Biochemical Engineering
- Analytical Chemistry
- Cosmetic Ingredient
-
Pharmaceutical Intermediates
Promotion
ECHEMI Mall
Wholesale
Weekly Price
Exhibition
News
-
Trade Service
*It is only for medical professionals to read for reference.
There are classic "troika" in the treatment of thyroid cancer, one of which is iodine-131 treatment! In recent years, the incidence of thyroid cancer has continued to increase, and its treatment has become a hot spot of public concern, especially the treatment of iodine-131.
Many people are unfamiliar and interested in it.
The'medical community' invited Professor Chen Libo, the deputy director of the Nuclear Medicine Research Office of the Sixth People's Hospital affiliated to Shanghai Jiaotong University and the executive vice chairman of the Thyroid Cancer Committee of the Chinese Society of Clinical Oncology.
Professor Chen has done a lot of research on radionuclide diagnosis and treatment of thyroid cancer and other diseases.
I believe that through his remarks, everyone will have a deeper understanding of iodine-131 treatment.
Professor Chen Libo's wonderful video Introduction to Thyroid Cancer 101 Professor Chen Libo said that in the past 30 years, the incidence of thyroid cancer has shown a sustained and rapid increase in many countries and regions around the world, including my country.
There are nearly 600,000 new cases worldwide each year.
China accounts for about 1/6 of them, and the ratio of women to men is about 3:1.
Although thyroid cancer is considered to be a malignant tumor with very low malignancy, some people even call it "lazy cancer".
In recent years, its clinical treatment has also been continuously improved, but the current 5-year survival rate of thyroid cancer patients in my country is only 84%, compared with 98% of American patients, there is still a big gap.
Pathologically, thyroid cancer is usually divided into papillary carcinoma, follicular carcinoma and undifferentiated carcinoma derived from thyroid follicular epithelial cells, and medullary carcinoma derived from parafollicular cells.
Most papillary thyroid carcinomas and follicular carcinomas are usually collectively referred to as differentiated thyroid cancer, and these patients have a relatively good prognosis.
Undifferentiated thyroid cancer has a poor prognosis.
It is usually in the advanced stage of the disease when it is diagnosed, and treatment is difficult.
The patient's survival time is only about 6 months.
Medullary carcinoma is relatively inert, and its biological progress is slower than that of undifferentiated carcinoma, but it is prone to distant metastasis.
There is a "troika" in the treatment of thyroid cancer, and iodine-131 is very important! At present, the conventional treatment for differentiated thyroid cancer includes surgical treatment + iodine-131 treatment + thyroxine replacement/inhibition treatment, which is called the "troika" of treatment.
Ablation, external irradiation, intervention, anti-angiogenesis, immunity and other treatment methods are necessary and beneficial supplements to conventional treatment methods.
In the classic "troika", iodine-131 treatment is a relatively unfamiliar and mysterious treatment.
Professor Chen Libo introduced that iodine-131 is one of the radioisotopes of stable iodine-127, which can be absorbed by the intestine through oral administration, enter the blood circulation, and finally locate in the residual thyroid tissue and residual or recurring lesions after thyroid cancer surgery.
Iodine-131 produces radiation biological effects by emitting β rays to destroy thyroid and cancer tissues, so as to eliminate residual thyroid tissue, reduce the risk of recurrence of thyroid cancer, and destroy residual, recurrence and metastasis.
At the same time, it can also emit gamma rays with an energy of 364keV, which can be imaged by medical imaging equipment to realize the location and qualitative diagnosis of cancer, as well as the restaging and prognostic evaluation of the disease.
It is not difficult to see that iodine-131, as an integrated radiopharmaceutical for diagnosis and treatment, plays a vital role in the precise diagnosis and targeted therapy of differentiated thyroid cancer.
The generalized postoperative iodine-131 treatment for differentiated thyroid cancer can be divided into three types: iodine-131 ablation, iodine-131 adjuvant treatment and iodine-131 treatment.
At present, it is believed that simple iodine-131 ablation is suitable for low-risk patients, and the recommended dose is 30-150 mCurie; iodine-131 adjuvant therapy is suitable for middle- and high-risk patients, and the appropriate dose is 100-150 mCurie; iodine-131 treatment is It is suitable for primary and metastatic differentiated thyroid cancer that cannot be operated or incompletely removed by surgery.
The recommended dose range is 150-250 millicuries.
What is the value of iodine-131 treatment? Professor Chen Libo gave an example.
For patients who have undergone residual methyl iodine-131 ablation, if the efficacy is evaluated as complete remission, they usually only need to monitor serum thyroid function, thyroglobulin and their antibodies during follow-up.
Frequent imaging examinations are not necessary.
Follow-up has become more convenient. At the same time, there is an objective basis for judging the cure, which will give both doctors and patients great confidence in the ultimate victory of the disease.
For another example, after high-functioning thyroid cancer lesions are treated with iodine-131, not only will the tumor shrink and decrease, but the thyrotoxicosis will also be well controlled, and the general condition of the patient can be fundamentally improved, which is currently difficult to achieve with other treatments.
.
It can be seen that postoperative iodine-131 treatment for patients with differentiated thyroid cancer is very beneficial and necessary.
Of course, iodine-131 treatment also has its powerlessness.
Some thyroid cancer lesions cannot take iodine-131; or although they can take it, the condition is still progressing; or the treatment is repeated and the dose has been larger (more than 600 millicuries), but the condition has not improved.
Such lesions can be called iodine-131 refractory thyroid cancer.
However, with the continuous advancement of technology and the vigorous development of research, more and more patients with iodine-131 refractory thyroid cancer have been effectively controlled.
At present, the innovation of related drug research and development and treatment schemes is ongoing and it is worth looking forward to.
These things need to be done before and after treatment! Before iodine-131 treatment, both doctors and patients should cooperate with each other to ensure the effect: patients should avoid taking iodine-containing food or drugs within 1 month, and avoid receiving enhanced CT examinations within 2 months, so as not to be occupied by stable iodine.
Treatment targets reduce the efficacy of iodine-131; stop taking levothyroxine sodium tablets (LT4) for about 4 weeks or inject human recombinant thyroid-stimulating hormone (rh-TSH) to increase serum TSH levels to ensure that iodine-131 is adequate Utilization; the treating doctor will do a dynamic risk stratification for the patient to objectively evaluate the condition and choose the most reasonable treatment.
After the iodine-131 treatment is completed, we can’t sit back and relax.
Four things need to be done to ensure that the treatment is safe and effective: proper isolation and protection to protect family members and the public from radiation hazards; imaging after iodine-131 treatment for prediction Efficacy and development of follow-up treatment plan; promptly take LT4 under the guidance of doctors to correct hypothyroidism as soon as possible; regular follow-up visits to evaluate the efficacy and optimize the dosage of LT4. Of course, as with any treatment, side effects are sometimes unavoidable after iodine-131 treatment.
After taking large doses of iodine-131, some patients will experience acute radiation gastritis and acute thyroiditis such as nausea, vomiting, neck swelling and pain, and a few patients will also experience salivary gland swelling and pain.
Doctors usually do pretreatment before iodine-131 treatment to avoid or reduce the above symptoms.
After being discharged from the hospital, a small number of patients may experience salivary gland swelling due to poor drainage of the parotid duct when eating, and most of them can relieve themselves.
If necessary, it is recommended that the dentist visit a doctor for treatment.
A very small number of patients will experience impaired salivary gland function, causing dry mouth.
There is no good way to prevent it.
Drinking plenty of water can help relieve symptoms.
Expert profile Professor Libo Chen, chief physician, professor, and doctoral supervisor, deputy director of the Nuclear Medicine Research Office of the Sixth People’s Hospital Affiliated to Shanghai Jiaotong University, member of the Thyroid Tumor Committee of the Shanghai Anti-Cancer Association, and the Clinical Nuclear Medicine Committee of the Shanghai Nuclear Society Member, Deputy Leader of Therapeutics Group of Nuclear Medicine Branch of Shanghai Medical Association, Member of Thyroid Oncology Committee of Oncology Branch of Chinese Medical Association, Deputy Leader of Nuclear Medicine Group of Thyroid Diseases Committee of Chinese Research Hospital Association, Chinese Clinical Oncology Executive Vice Chairman of the Society of Thyroid Cancer Special Committee.
There are classic "troika" in the treatment of thyroid cancer, one of which is iodine-131 treatment! In recent years, the incidence of thyroid cancer has continued to increase, and its treatment has become a hot spot of public concern, especially the treatment of iodine-131.
Many people are unfamiliar and interested in it.
The'medical community' invited Professor Chen Libo, the deputy director of the Nuclear Medicine Research Office of the Sixth People's Hospital affiliated to Shanghai Jiaotong University and the executive vice chairman of the Thyroid Cancer Committee of the Chinese Society of Clinical Oncology.
Professor Chen has done a lot of research on radionuclide diagnosis and treatment of thyroid cancer and other diseases.
I believe that through his remarks, everyone will have a deeper understanding of iodine-131 treatment.
Professor Chen Libo's wonderful video Introduction to Thyroid Cancer 101 Professor Chen Libo said that in the past 30 years, the incidence of thyroid cancer has shown a sustained and rapid increase in many countries and regions around the world, including my country.
There are nearly 600,000 new cases worldwide each year.
China accounts for about 1/6 of them, and the ratio of women to men is about 3:1.
Although thyroid cancer is considered to be a malignant tumor with very low malignancy, some people even call it "lazy cancer".
In recent years, its clinical treatment has also been continuously improved, but the current 5-year survival rate of thyroid cancer patients in my country is only 84%, compared with 98% of American patients, there is still a big gap.
Pathologically, thyroid cancer is usually divided into papillary carcinoma, follicular carcinoma and undifferentiated carcinoma derived from thyroid follicular epithelial cells, and medullary carcinoma derived from parafollicular cells.
Most papillary thyroid carcinomas and follicular carcinomas are usually collectively referred to as differentiated thyroid cancer, and these patients have a relatively good prognosis.
Undifferentiated thyroid cancer has a poor prognosis.
It is usually in the advanced stage of the disease when it is diagnosed, and treatment is difficult.
The patient's survival time is only about 6 months.
Medullary carcinoma is relatively inert, and its biological progress is slower than that of undifferentiated carcinoma, but it is prone to distant metastasis.
There is a "troika" in the treatment of thyroid cancer, and iodine-131 is very important! At present, the conventional treatment for differentiated thyroid cancer includes surgical treatment + iodine-131 treatment + thyroxine replacement/inhibition treatment, which is called the "troika" of treatment.
Ablation, external irradiation, intervention, anti-angiogenesis, immunity and other treatment methods are necessary and beneficial supplements to conventional treatment methods.
In the classic "troika", iodine-131 treatment is a relatively unfamiliar and mysterious treatment.
Professor Chen Libo introduced that iodine-131 is one of the radioisotopes of stable iodine-127, which can be absorbed by the intestine through oral administration, enter the blood circulation, and finally locate in the residual thyroid tissue and residual or recurring lesions after thyroid cancer surgery.
Iodine-131 produces radiation biological effects by emitting β rays to destroy thyroid and cancer tissues, so as to eliminate residual thyroid tissue, reduce the risk of recurrence of thyroid cancer, and destroy residual, recurrence and metastasis.
At the same time, it can also emit gamma rays with an energy of 364keV, which can be imaged by medical imaging equipment to realize the location and qualitative diagnosis of cancer, as well as the restaging and prognostic evaluation of the disease.
It is not difficult to see that iodine-131, as an integrated radiopharmaceutical for diagnosis and treatment, plays a vital role in the precise diagnosis and targeted therapy of differentiated thyroid cancer.
The generalized postoperative iodine-131 treatment for differentiated thyroid cancer can be divided into three types: iodine-131 ablation, iodine-131 adjuvant treatment and iodine-131 treatment.
At present, it is believed that simple iodine-131 ablation is suitable for low-risk patients, and the recommended dose is 30-150 mCurie; iodine-131 adjuvant therapy is suitable for middle- and high-risk patients, and the appropriate dose is 100-150 mCurie; iodine-131 treatment is It is suitable for primary and metastatic differentiated thyroid cancer that cannot be operated or incompletely removed by surgery.
The recommended dose range is 150-250 millicuries.
What is the value of iodine-131 treatment? Professor Chen Libo gave an example.
For patients who have undergone residual methyl iodine-131 ablation, if the efficacy is evaluated as complete remission, they usually only need to monitor serum thyroid function, thyroglobulin and their antibodies during follow-up.
Frequent imaging examinations are not necessary.
Follow-up has become more convenient. At the same time, there is an objective basis for judging the cure, which will give both doctors and patients great confidence in the ultimate victory of the disease.
For another example, after high-functioning thyroid cancer lesions are treated with iodine-131, not only will the tumor shrink and decrease, but the thyrotoxicosis will also be well controlled, and the general condition of the patient can be fundamentally improved, which is currently difficult to achieve with other treatments.
.
It can be seen that postoperative iodine-131 treatment for patients with differentiated thyroid cancer is very beneficial and necessary.
Of course, iodine-131 treatment also has its powerlessness.
Some thyroid cancer lesions cannot take iodine-131; or although they can take it, the condition is still progressing; or the treatment is repeated and the dose has been larger (more than 600 millicuries), but the condition has not improved.
Such lesions can be called iodine-131 refractory thyroid cancer.
However, with the continuous advancement of technology and the vigorous development of research, more and more patients with iodine-131 refractory thyroid cancer have been effectively controlled.
At present, the innovation of related drug research and development and treatment schemes is ongoing and it is worth looking forward to.
These things need to be done before and after treatment! Before iodine-131 treatment, both doctors and patients should cooperate with each other to ensure the effect: patients should avoid taking iodine-containing food or drugs within 1 month, and avoid receiving enhanced CT examinations within 2 months, so as not to be occupied by stable iodine.
Treatment targets reduce the efficacy of iodine-131; stop taking levothyroxine sodium tablets (LT4) for about 4 weeks or inject human recombinant thyroid-stimulating hormone (rh-TSH) to increase serum TSH levels to ensure that iodine-131 is adequate Utilization; the treating doctor will do a dynamic risk stratification for the patient to objectively evaluate the condition and choose the most reasonable treatment.
After the iodine-131 treatment is completed, we can’t sit back and relax.
Four things need to be done to ensure that the treatment is safe and effective: proper isolation and protection to protect family members and the public from radiation hazards; imaging after iodine-131 treatment for prediction Efficacy and development of follow-up treatment plan; promptly take LT4 under the guidance of doctors to correct hypothyroidism as soon as possible; regular follow-up visits to evaluate the efficacy and optimize the dosage of LT4. Of course, as with any treatment, side effects are sometimes unavoidable after iodine-131 treatment.
After taking large doses of iodine-131, some patients will experience acute radiation gastritis and acute thyroiditis such as nausea, vomiting, neck swelling and pain, and a few patients will also experience salivary gland swelling and pain.
Doctors usually do pretreatment before iodine-131 treatment to avoid or reduce the above symptoms.
After being discharged from the hospital, a small number of patients may experience salivary gland swelling due to poor drainage of the parotid duct when eating, and most of them can relieve themselves.
If necessary, it is recommended that the dentist visit a doctor for treatment.
A very small number of patients will experience impaired salivary gland function, causing dry mouth.
There is no good way to prevent it.
Drinking plenty of water can help relieve symptoms.
Expert profile Professor Libo Chen, chief physician, professor, and doctoral supervisor, deputy director of the Nuclear Medicine Research Office of the Sixth People’s Hospital Affiliated to Shanghai Jiaotong University, member of the Thyroid Tumor Committee of the Shanghai Anti-Cancer Association, and the Clinical Nuclear Medicine Committee of the Shanghai Nuclear Society Member, Deputy Leader of Therapeutics Group of Nuclear Medicine Branch of Shanghai Medical Association, Member of Thyroid Oncology Committee of Oncology Branch of Chinese Medical Association, Deputy Leader of Nuclear Medicine Group of Thyroid Diseases Committee of Chinese Research Hospital Association, Chinese Clinical Oncology Executive Vice Chairman of the Society of Thyroid Cancer Special Committee.
