甲狀腺癌術後病人採低碘飲食持續時間對尿碘濃度之影響

本研究目的為探討甲狀腺癌術後病人採低碘飲食的持續時間對尿碘濃度之影響。依據PICO（Population-Intervention-Comparison-Outcome）方式設立臨床問題，P為甲狀腺癌行甲狀腺術後預計行放射碘治療病人；I為小於等於二週低碘飲食；C為大於二週低碘飲食；O為尿碘、碘／肌酐（I/Cr）比值變化。以系統性文獻回顧法，搜尋資料庫包括華藝線上圖書館、PubMed、The Cochrane Library、Embase資料庫，使用關鍵字包含甲狀腺切除手術（Thyroidectomy）、放射線碘治療（Radioactive iodine treatment：RIT）、低碘飲食（Low iodine diet：LID）及尿碘濃度（Urine iodine concentration），最後選擇5篇符合主題之文獻，分別為二篇世代性研究、二篇隨機控制試驗、一篇系統性文獻回顧，依照Oxford CEBM建議等級，證據等級1-3，統整結果顯示放射碘治療前進行低碘飲食1〜2週，即可達到治療成效，與限碘飲食無差異，並建議未來須進行放射線碘治療患者，進行前持續低碘飲食1-2週即可。

關鍵字

甲狀腺癌；甲狀腺切除手術；放射線碘治療；低碘飲食；尿碘濃度

並列摘要

The purpose of this study was to investigate the effect of the duration of a low iodine diet on urinary iodine concentration in patients with thyroid cancer after thyroidectomy. According to the PICO (Population- Intervention-Comparison-Outcome) method to establish clinical problems, Population is patients with thyroid cancer who have completed thyroidectomy and will undergo radioiodine treatment; Intervention is less than or equal to two weeks of low iodine diet; Comparison is more than two weeks of low iodine diet; Outcome is the urine iodine and iodine/creatinine (I/Cr) ratio. A systematic review was conducted. Electronic databases including, Cochrane Library, EBSCO, PubMed and Airiti library were retrieved for relevant articles. Finally, 5 articles that match the inclusion criteria were selected including 2 cohort studies, 2 randomized controlled trials (RCT), and 1 systematic review (SR). Based on the five studies, it is validated that using low-iodine diet 1 to 2 weeks before radioiodine treatment can achieve the optimal therapeutic effect with the evidence on level 1 to level 3 according to 2011 OCEBM. As a result, it is recommended that patients who receive radiation iodine should be educated for low-iodine diet for 1~2 weeks before the treatment.

並列關鍵字

thyroid cancer ； thyroidectomy ； radioactive iodine ； low iodine diet ； urine iodine concentration

參考文獻

黃兆駿、汪姍瑩、陳雅凰等：甲狀腺癌患者消融治療時的 I-131 體內動力學研究。臺灣醫事放射期刊2018;6:9-18。

Li JH, He ZH, Bansal V, et al. Low iodine diet in differentiated thyroid cancer: a review. Clinical Endocrinology 2016;84:3-12.

Luster M, Clarke S, Dietlein M, et al. Guidelines for radioiodine therapy of differentiated thyroid cancer. Eur J Nucl Med Mol Imaging 2008;35: 1941-59.

Cooper DS, Doherty GM, Haugen BR, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association (ATA) guidelines taskforce on thyroid nodules and differentiated thyroid cancer. Thyroid 2009;19:1167-214.

Pacini F, Schlumberger M, Dralle H, et al. European consensus for the management of patients with differentiated thyroid carcinoma of the follicular epithelium. Eur J Endocrinol 2006;154:787-803.

延伸閱讀

Chen, C. Y., Liu, W. S., Chung, M. J., Yang, S. H., Chang, P. J., & Lin, D. B. (2005). 分化良好甲狀腺癌的放射碘治療：甲狀腺近全切除患者的體內劑量估算. 中山醫學雜誌, 16(2), 335-344. https://doi.org/10.30096/CSMJ.200512.0014
黃兆駿（2018）。甲狀腺全切除病人的碘-131體內動力學研究〔碩士論文，中臺科技大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0099-2705202017052336
Lee, P. I., You, D. L., Hsu, Y. L., Chen, J., Huang, Y. Y., & Wu, Y. Y. (2007). 氟－18-去氧葡萄糖正子電腦斷層掃描於甲狀腺球蛋白升高而碘－131掃描陰性之復發性甲狀腺癌病人的臨床應用. 核子醫學雜誌, 20(4), 179-185. https://doi.org/10.6332/ANMS.2004.001
Lin, K. H., Wan, C. H., Shih, B. F., Tsao, C. H., & Wu, M. C. (2015). 低劑量放射碘治療甲狀腺功能亢進：台灣北部一家教學醫院之經驗. 核子醫學暨分子影像雜誌, 28(2), 72-78. https://doi.org/10.6332/ANMMI.2802.003
Ha, T. K., Kim, D. W., Park, H. K., Baek, J. W., Lee, Y. J., Park, Y. M., Kim, D. H., Jung, S. J., & Ahn, K. J. (2016). The Effect of Levothyroxine Discontinuation Timing on Postoperative Hypothyroidism after Hemithyroidectomy for Papillary Thyroid Microcarcinoma. International Journal of Endocrinology, 2016(), 410-415-045. https://doi.org/10.1155/2016/3240727

國際替代計量

甲狀腺癌術後病人採低碘飲食持續時間對尿碘濃度之影響

全文下載

主題瀏覽