International Czech and Slovak cooperation in the treatment of patients with differentiated thyroid cancer

摘要

BACKGROUND : The aim of this paper is to present our experience concerning cooperation in the treatment of Slovak patients with differentiated thyroid cancer in Slovak and Czech hospitals. The objectives of this study were to demonstrate the means of this cooperation and the results of therapy. MATERIAL AND METHODS : From September 1991 to October 2005 in the Department of Nuclear Medicine in Ostrava 357 patients from the Slovak Republic with differentiated thyroid cancers (follicular and papillary) underwent complex therapy. They were diagnosed and operated due to the cancer (near-total thyroidectomy and removal of lymph node metastases) in Slovak hospitals. Then they were sent to the Department of Nuclear Medicine in Ostrava in the Czech Republic. In this department a radioiodine ablation of thyroid remnants, by means of the treatment amount of radioiodine of a standard activity of 3.7 GBq, was performed, and then a suppression and substitution therapy of thyroid hormones was started. After 3-6 months some patients were examined by means of diagnostic whole body scintigraphy after application of 300 MBq 131 I. Some patients were treated by means of a standard activity of 7.4 GBq 131 I and after 5 days whole body scintigraphy (WBS) was performed. In both of these groups of patients the diagnostic or therapeutic radioiodine application was done after withdrawal of thyroid hormone treatment. If thyroglobulin levels were low and WBSs were negative, patients were followed up in the Department of Nuclear Medicine in Martin. Patients with radioiodine accumulated metastases were again treated with radioiodine in Ostrava. If indicated, external radiation therapy targeted on the neck and upper mediastinum was performed in the Slovak Republic, in the University Hospital in Martin. Newly formed lymph node metastases were surgically treated in Slovakia, too. Generally we have very good treatment results. Also, economically our partnership is cost effective. Our collaboration also successfully continues after entrance of the Slovak Republic and the Czech Republic to the European Union in 2004. CONCLUSIONS : The results of this multi-centre study show that international Czech and Slovak cooperation in the complex therapy of patients with differentiated thyroid cancers is successful, with high efficacy. The treatment results were very similar to therapeutic results in our patients from the Czech Republic.