scholarly journals Radioiodine Ablation for Thyroid Cancer. Historical and Modern Aspects. Literature Review

2021 ◽  
Vol 4 (4) ◽  
pp. 9-19
Author(s):  
A. Yu. Shurinov ◽  
V. V. Krylov ◽  
E. V. Borodavina
Keyword(s):  
Thyroid Cancer ◽  
Radioiodine Therapy ◽  
Combined Treatment ◽  
Thyroid Tissue ◽  
Endocrine System ◽  
Distant Metastases ◽  
Residual Tumor ◽  
Recurrence Risk ◽  
Follicular Epithelium ◽  
Radioiodine Ablation

Thyroid cancer is the most common oncological pathology of the endocrine system organs with a continuing trend towards an increase in the incidence. Radioiodine therapy (RIT) is the second stage of combined treatment, it is carried out only as an adjuvant treatment, it is an uncontested method of radio-targeted therapy for distant metastases of differentiated thyroid cancer (DTC). The method of radioiodine therapy is based on the unique natural affinity of iodine atoms for the follicular epithelium of the thyroid gland and DTC cells. Determination of indications for RIT is based on stratification of recurrence risk, persistence, and disease prevalence. Over the past 15 years, the world’s leading professional communities have repeatedly revised approaches to risk stratification. Consideration of the mutational profile of the tumor and the theranostic approach have become significant innovations.Radioiodine therapy can be presented in the form of three modes: ablation of residual thyroid tissue, treatment of residual tumor and treatment of distant metastases. These regimens differ in the administered therapeutic activity of 131I, which looks logical from the point of view of the necessary personalization of the treatment. At the same time, in scientific circles, disputes about the absence of significant differences in the used therapeutic activities of 131I prescribed for radioiodine ablation outside the personalized approach do not subside.

scholarly journals Efficacy of Low-Dose Radioiodine Ablation in Low- and Intermediate-Risk Differentiated Thyroid Cancer: A Retrospective Comparative Analysis

2020 ◽  
Vol 9 (2) ◽  
pp. 581
Author(s):  
Ana María Gómez-Pérez ◽  
Jorge García-Alemán ◽  
María Molina-Vega ◽  
Arantzazu Sebastián Ochoa ◽  
Pilar Pérez García ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Dose Group ◽  
Low Dose ◽  
Recurrence Risk ◽  
High Dose ◽  
Intermediate Risk ◽  
Initial Recurrence ◽  
Radioiodine Ablation ◽  
Antithyroglobulin Antibodies ◽  
The Moment

(1) Background—low-dose radioiodine ablation is an accepted strategy for the treatment of low- and intermediate-risk thyroid carcinomas, although there is no international consensus. The aim of this study is to describe the clinical experience with low-dose radioiodine ablation in patients with low- and intermediate-risk thyroid cancer compared to high-dose ablation. (2) Methods—174 patients with low- and intermediate-risk thyroid cancer, 90 treated with low-dose ablation and 84 treated with high-dose ablation, were included. The primary endpoint was response to treatment one year after ablation, defined by stimulated thyroglobulin, whole body scan and ultrasound imaging. (3) Results—an excellent response rate of 79.8% in the low-dose group and 85.7% in the high-dose group was observed (p = 0.049). Stimulated thyroglobulin at the moment of ablation (p = 0.032) and positive antithyroglobulin antibodies (p < 0.001) were independent predictive factors for nonexcellent response. Young age (p = 0.023), intermediate initial recurrence risk (p < 0.001) and low-dose ablation (p = 0.004) were independent predictive factors for recurrence. (4) Conclusion—low-dose ablation seemed to be less effective than high-dose ablation, especially in those patients with positive antithyroglobulin antibodies or higher stimulated thyroglobulin levels at the moment of ablation. Low dose was associated with higher recurrence rates, and lower age and intermediate initial recurrence risk were independent risk factors for recurrence in our sample.

scholarly journals Acromegaly and thyroid cancer: analysis of evolution in a series of patients

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Karina Danilowicz ◽  
Soledad Sosa ◽  
Mariana Soledad Gonzalez Pernas ◽  
Elizabeth Bamberger ◽  
Sabrina Mara Diez ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Median Time ◽  
Staging System ◽  
Distant Metastases ◽  
Tnm Staging ◽  
Control Group ◽  
Tumor Diameter ◽  
Delay In Diagnosis ◽  
Incomplete Response ◽  
Radioiodine Ablation

Abstract Background Acromegaly is associated with higher morbidity and mortality mainly due to cardiovascular disease. Data on the incidence and evolution of thyroid cancer in acromegaly are controversial. Our objective was to describe the characteristics of a group of acromegalic patients with differentiated thyroid carcinoma (DTC) and analyze their evolution. Methods This is a retrospective multicenter study of 24 acromegalic patients with DTC. The AJCC Staging System 8th Edition was used for TNM staging, and the initial risk of recurrence (RR), initial response and response at the end of follow-up (RFU) were defined according to the 2015 ATA Guidelines. As a control group, 92 patients with DTC without acromegaly were randomly included. Statistical analyses were done using SPSS Statistics 20.0. Results Median age of patients at diagnosis of acromegaly was 49.5 years (range 12–69). The median delay in diagnosis of acromegaly was 3 years (range 0.5–23). Mean baseline IGF-1 level was 2.9 ± 1.1 ULN. Median age at DTC diagnosis was 51.5 years (18–69). At the moment of diagnosis of DTC, 58.3% of the patients had active acromegaly. Median time from DTC diagnosis to acromegaly control was 1.25 years (0.5–7). Mean DTC tumor diameter of the biggest lesion was 14.6 ± 9.2 mm, being multifocal in 37.5%. All tumors were papillary carcinomas, two cases being of an aggressive variety. Lymph node dissection was performed in 8 out of 24 patients and 62.5% had metastases. Only one patient had distant metastases. Radioiodine ablation was given to 87.5% of patients. Nineteen patients (79%) were stage I, four (17%) stage II and one (4%) stage IVb. Initial RR was low in 87% (21/24), intermediate in 9% (2/24) and high in 4% (1/24) patient. RFU was: 83% (19/23) patients with no evidence of disease, 9% (2/23) with indeterminate response, 4% (1/23) with biochemical incomplete response and 4% (1/23) with structural incomplete response, at a median time of FU of 36.5 months. When comparing RFU between acromegalics and controls no statistically significant differences were found. Conclusions Patients with acromegaly and DTC mostly had a low initial RR. When compared with the control group, we found that DTC patients with acromegaly did not have a worse evolution.

scholarly journals Deregulation of microRNA expression in follicular cell-derived human thyroid carcinomas

2010 ◽  
Vol 17 (1) ◽  
pp. F91-F104 ◽  
Author(s):  
Pierlorenzo Pallante ◽  
Rosa Visone ◽  
Carlo Maria Croce ◽  
Alfredo Fusco
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Thyroid Tissue ◽  
Endocrine System ◽  
Follicular Carcinoma ◽  
Thyroid Neoplasms ◽  
Anaplastic Thyroid Cancer ◽  
Microrna Expression ◽  
Human Thyroid ◽  
Thyroid Carcinomas

Carcinoma of the thyroid gland is an uncommon cancer, but one of the most frequent malignancies of the endocrine system. Most thyroid cancers are derived from the follicular cells. Follicular carcinoma is considered more malignant than papillary thyroid carcinoma (PTC), and anaplastic thyroid cancer (ATC) is one of the most lethal human cancers. Even though several genetic lesions have been already described in human thyroid cancer, particularly in the papillary histotype, the mechanisms underlying the development of these neoplasias are still far from being completely elucidated. Some years ago, several studies were undertaken to analyze the expression of microRNAs (miRNAs or miRs) in thyroid carcinoma to evaluate a possible role of their deregulation in the process of carcinogenesis. These studies showed an aberrant microRNA expression profile that distinguishes unequivocally among PTC, ATC, and normal thyroid tissue. Here, other than summarizing the current findings on microRNA expression in human thyroid carcinomas, we discuss the mechanisms by which microRNA deregulation may play a role in thyroid carcinogenesis, and the possible use of microRNA knowledge in the diagnosis and therapy of thyroid neoplasms.

scholarly journals Clinical significance of the BRAFV600E mutation in PTC and its effect on radioiodine therapy

2019 ◽  
Vol 8 (6) ◽  
pp. 754-763 ◽  
Author(s):  
Guoquan Zhu ◽  
Yuying Deng ◽  
Liqin Pan ◽  
Wei Ouyang ◽  
Huijuan Feng ◽  
...  
Keyword(s):  
Radioactive Iodine ◽  
Radioiodine Therapy ◽  
Distant Metastases ◽  
Recurrence Risk ◽  
Capsular Invasion ◽  
Wild Type ◽  
Significant Difference ◽  
Clinicopathologic Factors ◽  
Relationship Of ◽  
The Relationship

The goal of this study was to explore the relationship of the BRAFV600E mutation with clinicopathologic factors and evaluate the effect of radioactive iodine (RAI) therapy in a large group of intermediate- and high-risk papillary thyroid cancer (PTC) patients with the BRAFV600E mutation and without distant metastases. We collected data for PTC patients who underwent total or near-total thyroidectomy and RAI treatment in our hospital from January 2014–December 2017. There were 1220 PTC patients who met the criteria, and the BRAFV600E mutation was observed in 979 of them (80.2%). Multivariate analysis identified that the BRAFV600E mutation remained independently associated with age at diagnosis, and bilaterality (OR = 1.023, 95% CI = 1.012–1.039, P < 0.001; OR = 1.685, 95% CI = 1.213–2.341, P = 0.002, respectively). In addition, the patients with bilateral PTCs had a higher prevalence of extrathyroid invasion, capsular invasion and fusion of metastatic lymph nodes than the unilateral PTC patients. The response to RAI therapy was evaluated in both the entire series and the patients with a high recurrence risk; no significant difference was discerned between the BRAFV600E mutation and the wild-type groups (P = 0.237 and P = 0.498, respectively). To summarize, our results confirmed that PTC patients with the BRAFV600E mutation exhibit more aggressive characteristics. In addition, the patients with bilateral PTC have a higher incidence of extrathyroid invasion. Moreover, BRAFV600E mutation PTC patients did not show a poorer clinical response after postsurgical RAI therapy, suggesting that RAI therapy may improve the general clinical outcome of these patients.

Thyroid Cancer Incidentally Found in Radical Surgery for Laryngeal/Hypopharyngeal Cancer

2009 ◽  
Vol 141 (3) ◽  
pp. 343-346 ◽  
Author(s):  
Chien Shih ◽  
Cheng-Ping Wang ◽  
Pei-Jen Lou ◽  
Ya-Ling Hu ◽  
Tsung-Lin Yang ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Laryngeal Cancer ◽  
Radical Surgery ◽  
Thyroid Tissue ◽  
Case Series ◽  
Distant Metastases ◽  
Hypopharyngeal Cancer ◽  
Conservative Approach ◽  
Retrospective Case ◽  
One Year

OBJECTIVES: To report on four patients with thyroid cancer found in their specimen of laryngectomy for laryngeal/hypopharyngeal cancer. STUDY DESIGN: Retrospective case series. SETTING: Patients with laryngeal cancer and hypopharyngeal cancers treated at our institution between 1991 and 2005 were enrolled. SUBJECTS AND METHODS: There were 463 patients with laryngeal cancer and 219 patients with hypopharyngeal cancers under retrospective review. RESULTS: There were 254 patients with laryngeal caner and 130 patients with hypopharyngeal cancer receiving surgery. Thyroid cancer was observed in the resected thyroid gland in two cases of laryngeal cancer and in two cases of hypopharyngeal cancer. They received treatment only for their laryngeal/hypopharyngeal cancers. Two patients died of distant metastases from larynx/hypopharynx cancer within one year. The other two patients are currently alive without disease from either of the two types of cancer. CONCLUSIONS: It is rare to discover an unexpected simultaneous thyroid cancer confirmed postoperatively from thyroid tissue partially removed in laryngectomy. A conservative approach is suggested for such patients.

scholarly journals Recombinant human thyrotropin in radioiodine diagnostics and radioiodine ablation of patients with well-differentiated thyroid cancer: the first experience in Russia

2018 ◽  
Vol 12 (3) ◽  
pp. 128-139
Author(s):  
Ivan I. Dedov ◽  
Pavel O. Rumyantsev ◽  
Ksenia S. Nizhegorodova ◽  
Konstantin Y. Slashchuk ◽  
Valentina S. Yasyuchenya ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Side Effects ◽  
Thyroid Hormones ◽  
Differentiated Thyroid Cancer ◽  
Radioiodine Therapy ◽  
Thyroid Stimulating Hormone ◽  
Efficacy And Safety ◽  
Post Surgery ◽  
Radioiodine Ablation ◽  
Well Differentiated

Background. Traditional endogenous stimulation of thyroid-stimulating hormone (TSH) by means of long-term withdrawal of thyroid hormones for radioiodine diagnostics and radioiodine therapy causes severe hypothyroidism, which worsens patients’ general well-being and may lead to side effects and cause tumor growth and dissemination. Exogenous stimulation with recombinant human TSH (rh-TSH, thyrotropin-alfa) causes short-term increases in TSH levels and does not have the above-mentioned side effects. Purpose. To estimate the efficacy and safety of rh-TSH in preparation of patients with well-differentiated thyroid cancer for radioiodine diagnostics and radioiodine therapy. Methods. We conducted an interventional single-center prospective unblinded uncontrolled study of the efficacy and safety of thyrotropin-alfa to prepare patients with well-differentiated thyroid cancer to radioiodine diagnostics and post-surgery radioiodine ablation. The study included 88 patients with well-differentiated thyroid cancer: 54 patients were prepared for post-surgery radioiodine ablation; 34 patients – for radioiodine diagnostics to evaluate combined treatment efficacy and exclusion of tumor recurrence. The level of TSH, thyroglobulin, antibodies to thyroglobulin, whole body scintigraphy, and side effects were measured during exogenous stimulation with thyrotropin-alfa. Results. The level of TSH reached or exceed the target level (30 mIU/ml) 24 hours after the first injection of recombinant thyrotropin-alfa in 86% of patients; after 48 hours in 100%, the level exceeding 100 IU/ml was observed in 66 (75.1%) patients. The maximum levels of thyroglobulin and antibodies to thyroglobulin were reached 72 and 48 hours after the first injection, respectively. The injections of thyrotropin-alfa were well-tolerated by the patients. In the group for radioiodine diagnostics 2 (5.8%) patients complained of fatigue, 1 (2.9%) patient had signs of dyspeptic disorder, while in the group for radioiodine ablation 4 (7.4%) patients complained of fatigue, 1 (1.8%) patient had marked memory problems that disappeared later (they must have been caused by the patient’s advanced age (82 years)). Conclusions. Exogenous recombinant human thyroid-stimulating hormone (thyrotropin-alpha) is highly effective in preparation of patients with well-differentiated thyroid cancer for radioiodine diagnostics and radioiodine ablation. It does not have side effects, which are typical of withdrawal of thyroid hormones. The levels of thyroglobulin and antibodies to thyroglobulin measured 72 hours after the first injection of thyrotropin-alfa have the biggest diagnostic informative value.

scholarly journals Absorbed Dose Evaluation in Radioiodine Therapy with Different Approaches

Instruments ◽  
2019 ◽  
Vol 3 (3) ◽  
pp. 39
Author(s):  
Mazzaglia ◽  
Stella ◽  
Tonghi ◽  
Tuvé ◽  
Politi ◽  
...  
Keyword(s):  
Radioiodine Therapy ◽  
Absorbed Dose ◽  
Distant Metastases ◽  
Thyroid Stimulating Hormone ◽  
Human Thyroid ◽  
Additional Source ◽  
Dose Limit ◽  
Red Marrow ◽  
Radioiodine Ablation ◽  
Dosimetric Study

The main approach to differentiated thyroid cancer (DTC) therapy is still empiric, consisting of the administration of fixed activities. Repeated treatments, however, may have a stunning effect. An individualized dosimetric study may represent an important tool to determine the best activity to prescribe, in particular for patients with distant metastases or when therapy with recombinant human thyroid-stimulating hormone (rhTSH) stimulation is deemed necessary. This study provides a practical operational example for carrying out a dosimetric study, according to the European Directive EURATOM/59/13. Starting from the case of a patient who underwent rhTSH stimulation before radioiodine ablation, we illustrate the necessity of measuring both red marrow (RM) and blood (BL) absorbed dose during the treatment in order to not exceed the dose limit of 2 Gy to the RM, so as to avoid repeating radioiodine treatment several times. Dosimetry to the RM and BL was performed during the treatments, after administration of therapeutic activity without modifying the fixed activity schema, using different approaches. The results suggest the possibility of restricting the number of treatments, reducing thus the risk of stunning effect and, where possible, eliminating an additional source of stress and dejection for patients.

scholarly journals Mirna expression profiling of anaplastic thyroid cancer

2021 ◽  
Vol 67 (1) ◽  
pp. 70-76
Author(s):  
Margarita Knyazeva ◽  
Lidia Zabegina ◽  
Elena Sidina ◽  
Aleksey Karizky ◽  
Evgeniya Tsyrlina ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Tissue ◽  
Anaplastic Thyroid Cancer ◽  
Follicular Epithelium ◽  
Therapeutic Approaches ◽  
Rt Pcr ◽  
Rare Form ◽  
Normal Thyroid Tissue ◽  
Mirnas Expression ◽  
Mirna Expression Profiling

Introduction: Malignant transformation of follicular epithelium of the thyroid gland is associated with specific alterations of miRNA profile. Evaluation of miRNAs expression changes is being applied for primary or differential diagnostic of thyroid nodes. Anaplastic thyroid cancer (ATC) is relatively rare form of thyroid cancer with high malignant potency and rate of lethality. Investigation of miRNAs role in ATC might provide with soul for development of new diagnostic and therapeutic approaches. Goal: To analyze expression profile of miRNA in ATC and to identify miRNAs involved in pathogenesis of ATC. Material and Methods: Samples of ATC (n.20) and normal thyroid tissue (n. 22) were included in the study, expression levels of 85 cancer-associated miRNAs were analyzed by RT-PCR. Results: Expression of miR-375, miR-1246 and miR-21 is activated while expression of miR-Let7b, miR-125b and miR-181a is suppressed in cells of ATC. Conclusions: Further investigation of miRNA involvement into carcinogenesis of ATC is needed for development of new diagnostic and therapeutic approaches.

scholarly journals Value of 18F-fluorodeoxyglucose positron emission tomography combined with computed tomography in staging of patients with differentiated thyroid cancer after thyroidectomy during the first course of radioiodine therapy

2021 ◽  
Vol 10 (4) ◽  
pp. 16-24
Author(s):  
T. M. Geliashvili ◽  
A. V. Vazhenin ◽  
T. P. Berezovskaya ◽  
E. B. Vasilieva ◽  
N. G. Afanasieva ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Radioiodine Therapy ◽  
Distant Metastases ◽  
Emission Tomography ◽  
18F Fluorodeoxyglucose ◽  
Positron Emission ◽  
Pet Ct ◽  
Tumor Persistence ◽  
Fluorodeoxyglucose Positron Emission

The study objective is to evaluate value of 18F-fluorodeoxyglucose positron emission tomography combined with computed tomography (PET-CT) and whole-body scintigraphy (131I-WBS) performed during the first course of radioiodine therapy for its ability to detect persistence metastatic foci and for its role in the management of differentiated thyroid cancer patients.Materials and methods. Forty patients with DTC underwent both post-therapeutic 131I-WBS and PET-CT. PET-CT performed on a positron emission tomograph combined with a 16-slice computer tomograph. Post-therapeutic 131I-WBS performed during radioiodine therapy on the single-detector gamma camera.Results. Sensitivity in detecting of the tumor persistence for PET-CT was 84 %, for post-therapeutic 131I-WBS 66 % (р >0.05). In 17 (42.5 %) patients additional PET-CT foci were found that negative on 131I-WBS, including 11 (27.5 %) cases of distant metastases. Fifteen percent of patients had metastatic foci visualized only on 131I-WBS, including 4 (10 %) cases of distant metastases. In 17 (44 %) patients tumor foci were identified by both methods. A high pre-ablative level of stimulated thyroglobulin was the only independent predictor of the presence of PET-CTpositive metastatic foci (p = 0.001).Conclusion. 18F-fluorodeoxyglucose PET-CT can be recommended during the first radioiodine therapy in differentiated thyroid cancer patients with a high risk progression group, as well as with suspected the tumor persistence in case of a high pre-ablation thyroglobulin level, to complete staging, improve the quality of management and ongoing risk stratification.

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