Alidadi S et al.Nucl Med Rev Cent East Eur. 2022;25(1):31-36.

碘-131广泛用于治疗甲状腺亢进，并且已经成为甲亢患者的首选药物。有报道称，碘-131增加患者癌症风险。褪黑素作为一种无毒的化合物已经被证实具有防辐射作用，该项研究的目的是证实褪黑素对使用碘-131治疗甲亢患者的疗效。

该项研究纳入52例患者，分为安慰剂组（n=24），褪黑素组（n=28），数据结果显示两组间，碘-131治疗前后患者的微核细胞数有显著差异（p＜0.0001），分别有62%和86%的患者对治疗有良好的反应（p=0.043）

研究结果表明，褪黑素组与安慰剂组相比显著改善患者临床结局，提高患者满意度，治疗效果更加明显

Abstract

Background: Since melatonin is a non-toxic compound with proven radioprotective effects, we aimed to investigate its efficacy in an in-vivo setting in hyperthyroid patients who are treated with iodine-131. This double-blind placebo-controlled study was conducted on hyperthyroid patients referred to nuclear medicine centers in Babol, Iran. We excluded patients suffering from hypertension treated with warfarin, autoimmune diseases, genetic diseases, cancers, smokers, chemical wounded, radiology and radiotherapy workers, and those who were treated with chemotherapy agents. Patients were randomly assigned to receive a capsule containing 300 mg of melatonin powder or a placebo. Just before receiving iodine-131, blood samples were taken from individuals. All 52 female patients received 10 to 20 mCi iodine-131 for treating hyperthyroidism. A second blood sample was taken one hour after the administration of iodine-131.

Material and methods: To determine the chromosomal damages before and after receiving radioiodine, we performed the cytokinesis- block micronucleus assay. Also, at phase 2, 6 months follow-up was performed, in which patients' positive responses to treatment were compared.

Results: The findings of this study indicate that the difference in micronucleus formation between the placebo and melatonin groups is not significant. However, a significant difference in the 6 months follow-up revealed that 61.5% and 85.7% of patients had a positive response to treatment in the placebo and melatonin groups, respectively.

Conclusions: As one of the first studies dealing with the human in-vivo assessment on the radioprotective effects of melatonin, it was concluded that melatonin has a non-significant positive impact on reducing the rate of chromosomal damages in hyperthyroid patients treated with iodine-131. Nevertheless, the outcome of treatment was significantly higher by melatonin compared to the placebo group.

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