scholarly journals 2022 ETA Consensus Statement: What are the indications for post-surgical radioiodine therapy in differentiated thyroid cancer?

2022 ◽  
Vol 11 (1) ◽  
Author(s):  
Furio Pacini ◽  
Dagmar Fuhrer ◽  
Rossella Elisei ◽  
Daria Handkiewicz-Junak ◽  
Sophie Leboulleux ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Randomized Trials ◽  
Radioactive Iodine ◽  
Consensus Statement ◽  
Radioiodine Therapy ◽  
Beneficial Effects ◽  
Risk Patients ◽  
Patient Preparation ◽  
Pre Treatment

Modern use of post-operative radioactive iodine (RAI) treatment for differentiated thyroid cancer (DTC) should be implemented in line with patients’ risk stratification. Although beneficial effects of radioiodine are undisputed in high-risk patients, controversy remains in intermediate-risk and some low-risk patients. Since the last consensus on post-surgical use of RAI in DTC patients, new retrospective data and results of prospective randomized trials have been published, which have allowed the development of a new European Thyroid Association (ETA) statement for the indications of post-surgical RAI therapy in DTC. Questions about which patients are candidates for RAI therapy, which activities of RAI can be used, and which modalities of pre-treatment patient preparation should be used are addressed in the present guidelines.

scholarly journals Canadian consensus statement on the management of radioactive iodine–resistant differentiated thyroid cancer

Oral Oncology ◽  
2021 ◽  
Vol 121 ◽  
pp. 105477
Author(s):  
Andrée Boucher ◽  
Shereen Ezzat ◽  
Sebastien Hotte ◽  
Irina Rachinsky ◽  
Murali Rajaraman ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Radioactive Iodine ◽  
Consensus Statement

scholarly journals Radioactive Iodine Administration Is Associated with Persistent Related Symptoms in Patients with Differentiated Thyroid Cancer

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Pablo Florenzano ◽  
Francisco J. Guarda ◽  
Rodrigo Jaimovich ◽  
Nicolás Droppelmann ◽  
Hernán González ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Salivary Gland ◽  
Adverse Effects ◽  
Differentiated Thyroid Cancer ◽  
Radioactive Iodine ◽  
Dry Mouth ◽  
Low Doses ◽  
Periorbital Edema ◽  
Risk Patients ◽  
Taste Disorders

Context. Radioiodine (RAI) administration has adverse effects in patients treated for thyroid cancer (DTC), but there is scarce information regarding their intensity and duration.Objective. To evaluate frequency and intensity of early and late RAI-related symptoms in patients with DTC.Design. Observational prospective study.Patients. DTC patients who underwent thyroidectomy, with or without RAI.Measurements. Patients answered 2 surveys: (1) from 0 to 6 months and (2) between 6 and 18 months after initial treatment.Results. 110 patients answered the first survey and 61 both. Nearly 80 percent received RAI. Among early symptoms, periorbital edema, excessive tearing, salivary gland disturbances, dry mouth, taste disorders, and nausea were more frequent and intense among RAI patients. Regarding late symptoms, periorbital edema, salivary gland pain and swelling, and dry mouth were more frequent and intense in RAI patients. Frequency and intensity of adverse effects were not different between low and high RAI doses (50 versus ≥100 mCi).Conclusion. RAI-related symptoms are frequent and usually persist after 6 months of administration, even when low doses are given. This finding must be considered when deciding RAI administration, especially in low risk patients, among whom RAI benefit is controversial.

Role of Radioactive Iodine for Adjuvant Therapy and Treatment of Metastases

2007 ◽  
Vol 5 (6) ◽  
pp. 631-640 ◽  
Author(s):  
Jacqueline Jonklaas
Keyword(s):  
Thyroid Cancer ◽  
Side Effects ◽  
Adjuvant Therapy ◽  
Cancer Cells ◽  
Differentiated Thyroid Cancer ◽  
Sodium Iodide ◽  
Radioactive Iodine ◽  
Radioiodine Therapy ◽  
Sodium Iodide Symporter ◽  
Thyroid Cancer Cells

Normal thyrocytes and thyroid cancer cells are characterized by possession of a sodium iodide symporter. Radioiodine administration is a unique and powerful means of treating differentiated thyroid cancer because of the ability of thyroid cancer cells to concentrate beta-emitting radiolabeled iodine. Several manipulations, such as iodine depletion and thyroid hormone-stimulating hormone elevation, are used to enhance uptake of radiolabeled iodine by tumor cells. Adjuvant radioiodine therapy, given to patients without evidence of residual disease, enhances the sensitivity of subsequent surveillance and may decrease recurrence rates and mortality. However, its exact role in the management of low-risk patients merits further investigation. In contrast, radioactive iodine therapy used in patients with residual or metastatic disease clearly improves outcomes. Several studies show decreased recurrence and mortality rates in patients treated with radioiodine compared with those not receiving radioactive iodine. Adverse events from radioiodine therapy include salivary gland dysfunction, bone marrow suppression, and reproductive disturbances. Side effects of radioiodine therapy are generally greater when higher activities of radioiodine are used and may be transient or permanent. Secondary malignancies also may occur after radioiodine therapy. These side effects must be weighed against potential benefits, especially when radioactive iodine is used as adjuvant therapy. Stimulation of the expression of the sodium iodide symporter, or its introduction de novo into nonthyroid cells, is promising in treating poorly differentiated thyroid cancer and nonthyroid malignancies, respectively.

MOLECULAR PROFILE AND CLINICAL OUTCOMES IN DIFFERENTIATED THYROID CANCER PATIENTS PRESENTING WITH BONE METASTASIS

2019 ◽  
Vol 25 (12) ◽  
pp. 1255-1262 ◽  
Author(s):  
Nilma Malik ◽  
Alyaksandr V. Nikitski ◽  
Elie Klam ◽  
Jason Hunt ◽  
Benjamin Witt ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Bone Metastasis ◽  
Primary Tumor ◽  
Differentiated Thyroid Cancer ◽  
Radioactive Iodine ◽  
Radioiodine Therapy ◽  
Molecular Profile ◽  
Follicular Variant ◽  
Primary Tumor Size ◽  
Ras Gtpase

Objective: Differentiated thyroid cancer patients uncommonly present with bone metastasis as the initial manifestation. Their molecular profile is largely unknown. The aim of this study was to evaluate the histopathology, molecular profiles, and response to radioactive iodine therapy in these patients. Methods: Eight patients presented with symptomatic bone metastasis from an unknown primary tumor. We identified these patients by performing a retrospective chart review. Pathology slides were reviewed and the molecular analysis of 112 thyroid cancer-related genes was performed on bone metastasis specimens using targeted next-generation sequencing. Results: These patients presented with long bone fractures, spinal cord compression, or intractable bone pain. Histopathologic analysis of the bone and thyroid tumor specimens revealed follicular variant of papillary carcinoma in 7 patients and tall cell variant papillary carcinoma in 1 patient. Primary tumor size ranged from 0.4 to 7.5 cm. All patients received high dose radioiodine therapy following thyroidectomy. Molecular analysis revealed telomerase reverse transcriptase ( TERT) mutations in 7 (88%) tumors, 4 (50%) contained co-occurring TERT and RAS GTPase gene ( RAS) mutations, 2 had isolated TERT mutations, and 1 had TERT and proto-oncogene B-Raf ( BRAF) V600E mutations, respectively. Tumors carrying RAS, TERT, or a combination of these mutations were radioiodine-avid, with predictable tumor response and reduction in serum thyroglobulin levels. One patient with radioiodine-refractory disease harbored BRAF and TERT mutations. Conclusion: These results demonstrate that differentiated thyroid cancers presenting with bone metastasis independent of the primary tumor size have a high prevalence of TERT mutations, frequently coexisting with RAS mutations. This molecular signature may predict a favorable response to radioiodine therapy. Abbreviations: BRAF = proto-oncogene B-Raf; DNA = deoxyribonucleic acid; DTC = differentiated thyroid cancer; FV = follicular variant; PTC = papillary thyroid carcinoma; RAI = radioactive iodine; RAS = Ras GTPase gene; TERT = telomerase reverse transcriptase; TG = thyroglobulin

Predictive factors determining incomplete response to radioiodine therapy in patients with differentiated thyroid cancer

2020 ◽  
Vol 64 (1) ◽  
Author(s):  
Ewelina Szczepanek-Parulska ◽  
Magdalena Wojewoda-Korbelak ◽  
Martyna Borowczyk ◽  
Malgorzata Kaluzna ◽  
Barbara Brominska ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Predictive Factors ◽  
Differentiated Thyroid Cancer ◽  
Radioiodine Therapy ◽  
Incomplete Response

scholarly journals Radioiodine therapy reduces the frequency of circulating tumour cells in patients with differentiated thyroid cancer

2021 ◽  
Author(s):  
Mathias Schmidt ◽  
Christina Antke ◽  
Katalin Mattes‐György ◽  
Hubertus Hautzel ◽  
Stephanie Allelein ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Radioiodine Therapy ◽  
Tumour Cells ◽  
Circulating Tumour Cells
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