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Endocrine. 2018 Dec;62(3):655-662. doi: 10.1007/s12020-018-1724-z. Epub 2018 Aug 25.

30mCi radioactive iodine achieving comparative excellent response in intermediate/high-risk nonmetastatic papillary thyroid cancer: a propensity score matching study.

Zhang Y1,2, Wang C1,2,3, Zhang X1,2, Li H1,2, Li X4, Lin Y5,6.

Author information

1
Department of Nuclear Medicine, Peking Union Medical College Hospital, Beijing, 100730, China.
2
Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Beijing, 100730, China.
3
Centre Médical Universitaire (CMU), Université de Genève, Geneva, Switzerland.
4
Department of Nuclear Medicine, Zhejiang Cancer Hospital, Hangzhou, 310022, China.
5
Department of Nuclear Medicine, Peking Union Medical College Hospital, Beijing, 100730, China. linys@pumch.cn.
6
Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Beijing, 100730, China. linys@pumch.cn.

Abstract

OBJECTIVE:

To determine the efficacy of low-dose radioactive iodine (RAI) therapy (30 mCi, 1110 MBq) in Chinese patients with intermediate- to high-risk papillary thyroid cancer (PTC) without distant metastasis.

DESIGN AND METHODS:

This large retrospective study included Chinese patients with PTC that tested negative for thyroglobulin antibodies. Patients were categorized into low-dose (30 mCi, 1110 MBq) and high-dose (>100 mCi, 3700 MBq) RAI groups. Ablation rate and long-term response were compared between groups using propensity score matching (PSM) to minimize bias and confounding.

RESULTS:

In total, we included 446 patients. No significant difference in ablation success rate was found between groups (P = 0.305) before or after PSM (N = 162; P = 0.200). Excellent response (ER) rate was not significant between groups before (P = 0.917) or after PSM (P = 0.798). Efficacy of low-dose RAI was similar to that of high-dose RAI in N0- (P = 1.000), N1a- (P = 0.981), and N1b-stage (P = 0.903) patients. Low- and high-dose RAI groups achieved similar ER rates in pre-ablative stimulated thyroglobulin level (≤1 ng/mL, P = 1.000; 1 < ps-Tg ≤ 5 ng/mL, P = 0.444; 5 < ps-Tg ≤ 10 ng/mL, P = 0.665; >10 ng/mL, P = 1.000) and BRAFV600E-positive (P = 0.324) subgroups.

CONCLUSIONS:

Efficacy of low-dose RAI therapy was similar to that of high-dose for ablation and achieving ER in Chinese nonmetastatic intermediate- to high-risk PTC patients. High-dose RAI could not rectify ablation failure or non-ER rates in PTC patients with BRAFV600E, lymph node metastases, or unfavorable thyroglobulin levels.

KEYWORDS:

Papillary thyroid cancer; Radioactive iodine therapy; Response; TNM staging

PMID:
30145748
DOI:
10.1007/s12020-018-1724-z
[Indexed for MEDLINE]

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