Assessment of radioiodine therapy efficacy for treatment of differentiated thyroid cancer patients with pulmonary metastasis undetected by chest computed tomography

ContextData from a large cohort of patients with pulmonary metastases from differentiated thyroid cancer (DTC) were retrospectively analyzed.ObjectiveTo assess the effect of radioiodine therapy and investigate the prognostic factors of survival for patients with pulmonary metastasis secondary to DTC.MethodsA total of 372 patients with pulmonary metastasis from DTC treated with131I entered the study. According to the results of131I whole-body scan (WBS), pulmonary metastases were classified as131I-avid and non-131I-avid. For patients with131I-avid lung metastases, treatment response was measured by three parameters: serum thyroglobulin (Tg) levels, chest computed tomography (CT) and post-therapeutic131I-WBS. Overall survival was calculated by the Kaplan–Meier method. Factors predictive of the outcome were determined by multivariate analyses.ResultsAmong patients demonstrating131I-avid pulmonary metastases (256/372, 68.8%), 156 cases (156/256, 60.9%) showed a significant decrease in serum Tg levels after131I therapy and 138 cases (138/229, 60.3%) showed a reduction in pulmonary metastases on follow-up CT. A complete cure, however, was only achieved in 62 cases (62/256, 24.2%). Multivariate analysis showed that only age, the presence of multiple distant metastases and pulmonary metastatic node size were significant independent variables between the groups of131I-avid and non-131I-avid.ConclusionThis study indicated that, most131I-avid pulmonary metastases from DTC can obtain partial or complete remission after131I therapy. Younger patients (<40 years old) with only pulmonary metastases and small (‘fine miliaric’ or micronodular) metastases appear to have relative favorite outcomes. Patients who do not respond to131I treatment have a worse prognosis.

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Outcome of radioiodine therapy in thyroid cancer patients with recent contrasted computed tomography

Nuclear Medicine Communications ◽

10.1097/mnm.0000000000001137 ◽

2020 ◽

Vol 41 (3) ◽

pp. 228-234

Author(s):

Justin D. Rodriguez ◽

Deepa Kirk ◽

Thad Benefield ◽

Susan J. Maygarden ◽

Karla Pou ◽

...

Keyword(s):

Computed Tomography ◽

Thyroid Cancer ◽

Cancer Patients ◽

Radioiodine Therapy

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The significance of clinic-diagnostic factors in the course of estimation of side exposure of differentiated thyroid cancer patients after radioiodine therapy

Radiation and Risk Bulletin of the National Radiation and Epidemiological Registry ◽

10.21870/0131-3878-2021-30-2-101-112 ◽

2021 ◽

Vol 30 (2) ◽

pp. 101-112

Author(s):

I.K. Khvostunov ◽

◽

V.V. Krylov ◽

A.A. Rodichev ◽

N.N. Shepel ◽

...

Keyword(s):

Thyroid Cancer ◽

Cancer Patients ◽

Chromosomal Aberrations ◽

Radionuclide Therapy ◽

Time Course ◽

Differentiated Thyroid Cancer ◽

Radioiodine Therapy ◽

Individual Characteristics ◽

Internal Exposure ◽

Whole Body

The radioiodine therapy is the most well-known branch of radionuclide therapy. The therapy composed of thyroidectomy and iodine-131 radiopharmaceutical is the “gold standard” for treat-ment of differentiated thyroid cancer patients (DTC). Given metastases in lymph nodes such therapy is absolutely exclusive treatment mode. At the same time, despite the targeted effect of radioiodine on pathological foci a side internal exposure of healthy organs and tissues is noted in the course of radioiodine therapy. Therefore, a reliable assessment of the side exposure is nec-essary taking into account the individual characteristics of patients considering that the side dose varies significantly from patient to patient. For this reason, the identification of significance of personal clinic-diagnostic factors determined the side whole body exposure is the vital and im-portant task. In this aspect, the cytogenetic examination of DTC patients by means of the analysis of chromosomal aberrations in peripheral blood lymphocytes is the goal of essential importance. The certain types of chromosomal aberrations are specific radiation markers that unequivocally indicate radiation exposure. Using the frequency of radiation markers the side absorbed dose can be reliably estimated. In the present work, the statistical analysis of the significance of vari-ous clinic-diagnostic factors in relation to the induction of radiation markers in the blood lympho-cytes was performed. For that end the results of the cytogenetic examination of the group com-prised of 38 DTC patients have been used. The examined patients underwent a course of radio-iodine therapy in the department of radionuclide therapy of the A.F. Tsyb MRRC, Obninsk. The slide preparation and cytogenetic analysis were carried out in the laboratory of radiation cytoge-netic of the same Center. The performed analysis of the correlation matrix with respect to the dependence of the increased frequency of stable and unstable markers resulted from a one-time course of radioiodine therapy showed no meaningfulness at the level R>0.3 for all the studied factors. For the absolute value of the frequency of radiation markers, both before and after radioiodine therapy, the meaningful relationship was found at the level R>0.7 for unsta-ble and at the level R>0.8 for stable markers with a total administered activity of radioiodine dur-ing all the previous courses of radioiodine therapy.

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