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Inicio Endocrinología y Nutrición Nuevos aspectos de tratamiento con yodo-131 en el cáncer diferenciado de tiroid...
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Vol. 48. Núm. 1.
Páginas 20-26 (enero 2001)
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Vol. 48. Núm. 1.
Páginas 20-26 (enero 2001)
Acceso a texto completo
Nuevos aspectos de tratamiento con yodo-131 en el cáncer diferenciado de tiroides
New aspects of iodine-131 treatment in patients with differentiated thyroid carcinoma
Visitas
5439
D. Fustera,**, I. Halperinb, S. Vidal-Sicarta, F. Lomeñaa
a Servicio de Medicina Nuclear
b Servicio de Endocrinología. Hospital Clínic. Barcelona
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La medicina nuclear interviene en el manejo clínico de los pacientes con cáncer diferenciado de tiroides. El yodo-131 refleja el funcionalismo tiroideo y permite detectar la presencia de tejido tiroideo y de tumor residual tras la tiroidectomía total. La administración de dosis altas de yodo-131 destruye los restos tiroideos tumorales e identifica y permite tratar nuevas lesiones tumorales locales o a distancia. Recientemente han aparecido nuevas técnicas que han variado ostensiblemente los procedimientos de actuación en estos pacientes. Entre ellas destaca el estímulo de tejido tiroideo con hormona estimuladora del tiroides (TSH) recombinante con el fin de evitar los síntomas derivados del hipotiroidismo previo al yodo-131 o la administración de ácido retinoico como factor de rediferenciación tumoral. En algunos casos, pueden tener relevancia la determinación de tiroglobulina o los estudios con PET con el objetivo de mejorar la exactitud diagnóstica en estos pacientes.

En este trabajo se revisa la situación actual de la medicina nuclear en el diagnóstico, tratamiento y seguimiento evolutivo de este tipo de tumores.

Palabras clave:
Carcinoma diferenciado de tiroides
Yodo-131

Nuclear Medicine plays a role in the clinical management of patients with differentiated thyroid cancer. Iodine-131 reflects thyroid function and enables the detection of the presence of residual thyroid tissue and tumor, after complete thyroidectomy. The administration of high doses of Iodine- 131 destroys thyroid tumoral remnants and identifies and treats new local and distant tumoral lesions. Recently new techniques have appeared such as the stimulation of thyroid tissue with recombinant TSH as a means of obviating hypothyroidism prior to studies with Iodine-131, or the administration of retinoic acid as a possible factor of tumoral redifferentiation. Furthemore, thyroglobulin or PET studies are also relevant in some cases in the attempt to improve accuracy in the diagnosis of tumors. In this work, the current situation in Nuclear Medicine in the diagnosis, treatment and follow up of these tumors is reviewed.

Key words:
Differentiated thyroid cancer
Iodine-131
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Copyright © 2001. Sociedad Española de Endocrinología y Nutrición
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