Radioiodine thyroid remnant ablation in patients with differentiated thyroid carcinoma (DTC): Prospective comparison of long-term outcomes of treatment with 30, 60 and 100 mCi

被引:49
作者
Kukulska A. [1 ]
Krajewska J. [1 ]
Gawkowska-Suwiska M. [1 ]
Puch Z. [1 ]
Paliczka-Cieslik E. [1 ]
Roskosz J. [1 ]
Handkiewicz-Junak D. [1 ]
Jarzab M. [1 ]
Gubaa E. [1 ]
Jarzab B. [1 ]
机构
[1] Department of Nuclear Medicine and Endocrine Oncology, M. Skodowska-Curie Memorial Cancer Center, Institute of Oncology, Gliwice Branch, Gliwice
关键词
Total Thyroidectomy; Differentiate Thyroid Cancer; Differentiate Thyroid Cancer; Thyroid Cancer Cell; Thyroid Remnant;
D O I
10.1186/1756-6614-3-9
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摘要
Background: The aim of this study is to compare the effectiveness of 131I therapy between three groups of DTC patients who received 30, 60 or 100 mCi for thyroid remnant ablation after total thyroidectomy and were postoperatively judged with low risk of cancer recurrence. Methods. The project was designed as a two-stage, prospective randomized clinical trial. In 1998-2001 in a randomized prospective study the early comparison of treatment with 30 mCi vs 60 mCi suggested the lower 131I activity to be less effective, whereas in 2003-2005 the comparison between 60 vs 100 mCi showed no significant differences. The present study comprises the long-term assessment of the disease course in 3 study groups. Results: A group of 309 DTC patients (285 women and 24 men) with no clinical, histopathological, sonographical or biochemical signs of persistent disease were included after total thyroidectomy and appropriate extent of neck lymph node dissection (265 with papillary and 44 with follicular thyroid cancer). For radioiodine thyroid remnant ablation, 30 mCi of 131I was applied in 86 patients, whereas 60 mCi in 128 and 100 mCi in 95 patients. The median follow-up was 10 years (2-12) for subjects treated with 30 mCi and 60 mCi and 6 years (2-6) for patients treated with 100 mCi of 131I. In the first evaluation, published previously, we observed that because of incomplete thyroid remnant ablation, the second 131I treatment was necessary in 10% patients, without difference between groups treated with 60 and 100 mCi and in 22% patients treated with 30 mCi. All patients entered full remission. To evaluate the long-term outcome of the adjuvant 131I treatment, the course of the follow-up and the most recent disease status were assessed by sonography, radiological examinations and serum Tg estimation (on LT4-suppressive treatment). Within the whole observation period local relapse was stated in 2 (2.4%), 4 (3%) and 3 (3%) patients treated with 131I activities of 30 mCi, 60 mCi and 100 mCi respectively and serum Tg concentration on LT4-suppressive treatment was low, without differences between groups. Conclusions: No significant differences in the 5 years efficacy of thyroid remnant radioiodine ablation using 30, 60 and 100 mCi were observed in low-risk DTC patients operated by total thyroidectomy and neck lymph node dissection. However, patients treated initially with 30 mCi, required second course of radioiodine in 22%, while this was necessary only in 13,3% and 11,2% of patients treated with 60 mCi and 100 mCi respectively. © 2010Kukulska et al; licensee BioMed Central Ltd.
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  • [1] Pacini F., Schlumberger M., Harmer C., Berg G.G., Cohen O., Duntas L., Jamar F., Jarzab B., Limbert E., Lind P., Reiners C., Franco F.S., Smit J., Wiersinga W., Post-surgical use of radioiodine (<sup>131</sup>I) in patients with papillary and follicular thyroid cancer and the issue of remnant ablation: A consensus report, European Journal of Endocrinology, 153, 5, pp. 651-659, (2005)
  • [2] Mazzaferri E.L., Thyroid remnant <sup>131</sup>I ablation for papillary and follicular thyroid carcinoma, Thyroid, 7, 2, pp. 265-271, (1997)
  • [3] McCowen K.D., Adler R.A., Ghaed N., Verdon T., Hofeldt F.D., Low dose radioiodide thyroid ablation in postsurgical patients with thyroid cancer, Am J Med, 61, pp. 52-8, (1976)
  • [4] Bal C., Padhy A.K., Jana S., Pant G.S., Basu A.K., Prospective randomized clinical trial to evaluate the optimal dose of 131 i for remnant ablation in patients with differentiated thyroid carcinoma, Cancer, 77, pp. 2574-80, (1996)
  • [5] Johansen K., Woodhouse N.J., Odugbesan O., Comparison of 1073 MBq and 3700 MBq iodine-131 in postoperative ablation of residual thyroid tissue in patients with differentiated thyroid cancer, J Nucl Med, 32, pp. 252-4, (1991)
  • [6] Maenpaa H.O., Heikkonen J., Vaalavirta L., Tenhunen M., Joensuu H., Low vs. high radioiodine activity to ablate the thyroid after thyroidectomy for cancer: A randomized study, PLoS ONE, 3, 4, (2008)
  • [7] Pacini F., Ladenson P.W., Schlumberger M., Driedger A., Luster M., Kloos R.T., Sherman S., Haugen B., Corone C., Molinaro E., Elisei R., Ceccarelli C., Pinchera A., Wahl R.L., Leboulleux S., Ricard M., Yoo J., Busaidy N.L., Delpassand E., Hanscheid H., Felbinger R., Lassmann M., Reiners C., Radioiodine ablation of thyroid remnants after preparation with recombinant human thyrotropin in differentiated thyroid carcinoma: Results of an international, randomized, controlled study, Journal of Clinic
  • [8] Gawkowska-Suwiska M., Ocena Wczesnej Skutecznoci Leczenia Uzupeniajcego Izotopem Jodu 131 i Chorych Na Zránicowanego Raka Tarczycy, (2003)
  • [9] Gawkowska-Suwiska M., Turska M., Roskosz J., Puch Z., Jurecka-Tuleja B., Handkiewicz-Junak D., Wygoda Z., Jarzab B., Early evaluation of treatment effectiveness using 131I iodine radiotherapy in patients with differentiated thyroid cancer, Wiad Lek, 54, SUPPL 1, pp. 278-88, (2001)
  • [10] Kukulska A., Krajewska J., Roskosz J., Handkiewicz-Junak D., Jarzab M., Paliczka E., Puch Z., Wygoda Z., Gubaa E., Jarzab B., Optimization of 131I ablation in patients with differentiated thyroid carcinoma: Comparison of early outcomes of treatment with 100 mCi versus 60 mCi, Pol J Endocrinol, 57, pp. 374-379, (2006)