Iodine-131 treatment of hyperthyroidism in the elderly. Results in 180 patients. Radioprotection and waste management in 131-iodine therapy

A retrospective study has been performed in patients treated by iodine-131 for hyperthyroidism between April 1999 and February 2004..Among the 270 patients, 180 were more than 65 years old. After 65 years, hyperthyroidism is most often the consequence of a toxic adenoma or multi-nodular goiter while Graves' disease is most frequent in young patients. Iodine-131 is usually proposed as first line treatment in the elderly, at the opposite of young patients. With a mean follow-up of 12 months, return to euthyroidism is observed in 56.5% of the older patients and in 73.6% of the young patients. We explain this results by the lower incidence of Graves' disease in the elderly. Nuclear medicine physicians are legally obliged to provide patients with a proper information about radioprotection. Recommendations should nevertheless not induce overdue nor illegitimate fear. They should not only be written and standardized, but also given orally and adapted to each patient. Urinary incontinence is not specific to the old patients, but it is more frequent after 65. Collection and storage of contaminated waste is sometimes difficult and has often to be solved on a case by case basis. (author)