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J Clin Endocrinol Metab. 2014 Jul;99(7):2433-40. doi: 10.1210/jc.2014-1405. Epub 2014 Apr 24.

No adverse affect in clinical outcome using low preablation diagnostic (131)i activity in differentiated thyroid cancer: refuting thyroid-stunning effect.

Author information

1
Departments of Clinical Oncology (B.K.Y.) and Nuclear Medicine (B.M.), The Christie National Health Service Foundation Trust, Manchester M20 4BX, England, United Kingdom.

Abstract

CONTEXT:

Published studies of thyroid stunning due to preablation (131)I scanning in the treatment of differentiated thyroid cancer after thyroidectomy had shown inconsistent clinical impact.

OBJECTIVE:

The objective of the study was to evaluate the clinical outcome in patients who were given a low diagnostic (131)I activity (1.1 mCi or 40 MBq) 6 days prior to radioiodine ablation (RAI).

DESIGN/SETTING:

Two cohorts of patients were treated in a cancer referral center in 2004-2011. The eligibility criteria were as follows: 1) diagnosis of differentiated thyroid cancer; 2) total or near total thyroidectomy; 3) no distant metastasis; and 4) receiving 82.4 mCi or greater (3050 MBq) therapeutic (131)I activity.

PATIENTS/INTERVENTIONS:

Three hundred five consecutive patients treated in 2004-2008 (group A) had a diagnostic activity 1.1 mCi of (131)I prior to RAI. The second cohort treated in 2009-2011 (group B) consisted of 237 patients who did not undergo diagnostic (131)I scanning prior to RAI.

MAIN OUTCOME MEASURES:

The tumor recurrence rate at 3 years and quantitative assessment using diagnostic whole-body radioiodine scans and TSH-stimulated thyroglobulin levels at 3-12 months after RAI were measured.

RESULTS:

The 3-year recurrence-free survival rates were 96.4% in both groups, with 4.3% in group A and 3.4% in group B having tumor recurrence (P = .91). The ablation success rates measured by diagnostic whole-body radioiodine scans were 97.6% and 100% and by stimulated thyroglobulin were 85.3% and 85.8% in group A and B, respectively (P = .62).

CONCLUSIONS:

The use of low diagnostic (131)I activity (1.1 mCi) given 6 days prior to RAI was safe and convenient without adversely affecting the long-term clinical outcome.

PMID:
24762114
DOI:
10.1210/jc.2014-1405
[Indexed for MEDLINE]

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