RESUMO
PURPOSE: Despite therapeutic effects of radioiodine in patients with differentiated thyroid cancer, there are some disadvantages due to harmful radiation to other tissues. According to the current guidelines, patients are recommended to drink lots of water and frequent voiding to reduce the amount of 131I in the body. This study was designed to assess the impact of the amount of liquid intake on reduction of the measured dose rate of radioiodine-treated patients. MATERIALS AND METHODS: A total of 42 patients with differentiated thyroid cancer without metastasis who had undergone total thyroidectomy and had been treated with radioiodine were selected. The patients were divided into two groups according to the amount of their fluid intake which was measured during the first 48 h after 131I administration. In all patients, the dose rate was measured immediately and 48 h after iodine administration. RESULTS: Each group included 21 patients. Dose rate ratio (the ratio of the second dose rate to the first dose rate) and dose rate difference ratio (the ratio of the difference between the two measured dose rates to the first dose rate) were calculated for each patient. Despite the significant difference in the amount of the liquid drunk, no statistically significant difference was seen between the different groups in parameters of dose-rate ratio and dose-rate difference ratio. CONCLUSION: Higher fluid intake (>60 ml/h in our study) alone would not effectively reduce the patient's radiation dose rate at least not more than a well-hydrated state. It seems that other interfering factors in the thyroidectomized patients may also have some impacts on this physiologic process.
RESUMO
BACKGROUND: Radioiodine therapy is used for the treatment of patients with differentiated thyroid cancer (DTC) who undergo total thyroidectomy. After radioiodine administration, regulations require to quarantine these patients until their retained activity reduces to <33 mCi. Some of the injected radioiodine is excreted by perspiration which helps dose reduction so that performing the activities which stimulate sweating such as exercise may shorten the time of dose reduction. To the best of our knowledge, this is the first study in the literature that has evaluated the impact of specific exercise program on the ambient equivalent dose of (131)I gamma rays. MATERIALS AND METHODS: Patients with DTC without metastasis who had undergone total thyroidectomy and were treated with radioiodine were included in this study. 30 patients were chosen among patients who were able to exercise, did not have renal failure, and did not use diuretics. Patients were divided into two control and intervention groups. Intervention group members walked on treadmills under a specific program, in 3 time intervals. The control group did not have any specific activity. Immediately after each exercise process, both groups took a shower, and their doses were measured by a survey dosimeter. RESULTS: It was revealed that there was a significant difference between mean values before and after each exercise time. The calculated P value which evaluates the overall impact was 0.939 which revealed that there was no significant difference between total ambient equivalent dose reductions of both groups. CONCLUSION: According to the study, it may conclude that sweating is an effective alternative way for radioiodine excretion, and if sweating is accompanied with well-hydrated status they may have synergism effect to shorten quarantine period. This could be an important consideration in patients which over-hydration is intolerable especially those with cardiac, liver, or renal problems.
