Does Radioiodine Therapy in Patients with Differentiated Thyroid Cancer Increase the Frequency of Another Malignant Neoplasm?

Objectives. To compare the frequency of another primary malignancy in patients with differentiated thyroid carcinoma (DTC) who received radioiodine therapy or not (131I). Material and Methods. 168 cases of DTC patients were retrospectively evaluated as to the frequency of another neoplasia by comparing patients with and without it, taking into account clinical, laboratory, and therapeutic parameters. Results. Another primary malignancy occurred in 8.9% of patients. Of these, 53.3% showed the malignancy before 131I and 46.7% after it. By comparing both groups, the age at the moment of diagnosis of another neoplasia was 46.1 ± 20.2 years for the group before 131I therapy and of 69.4 ± 11.4 years for the group after it (P=0.02). Of the 148 patients treated with 131I, 4.7% developed another malignancy. The latter were older (61 ± 17 years) than those who did not show another cancer type (44.1 ± 14.2 years) (P<0.05). Conclusion. The frequency of another neoplasia found after 131I was similar to that found before 131I.

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Should Treatment of Highly Differentiated Thyroid Carcinoma Be Conservative?

Nuklearmedizin ◽

10.1055/s-0037-1620594 ◽

1983 ◽

Vol 22 (01) ◽

pp. 20-23 ◽

Cited By ~ 1

Author(s):

B. Helpap ◽

U. Koch ◽

R. Janson ◽

C. Baumgarten ◽

C. Winkler ◽

...

Keyword(s):

Thyroid Cancer ◽

Lymph Node ◽

Thyroid Carcinoma ◽

Differentiated Thyroid Cancer ◽

Radioiodine Therapy ◽

Thyroid Tissue ◽

Differentiated Thyroid Carcinoma ◽

Therapeutic Concept ◽

Regional Metastases ◽

Node Metastases

On the basis of three selected cases (one with clinically occult follicular and two with metastatic papillary carcinoma) the necessity of a comprehensive therapeutic concept even in highly differentiated thyroid cancer is stressed. Thyroid tissue and regional metastases should be eliminated by surgery, followed by radioiodine therapy in any event. Radiation teletherapy should be reserved to patients with invasive tumor growth exceeding the organ capsule, with lymph node metastases, and with massive angioinvasive growth.

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Procedure guidelines for radioiodine therapy of differentiated thyroid cancer (version 3)

Nuklearmedizin ◽

10.1160/nukmed-0286 ◽

2007 ◽

Vol 46 (05) ◽

pp. 213-219 ◽

Cited By ~ 3

Author(s):

J. Dressler ◽

W. Eschner ◽

F. Grünwald ◽

M. Lassmann ◽

B. Leisner ◽

...

Keyword(s):

Thyroid Cancer ◽

Differentiated Thyroid Cancer ◽

Radioiodine Therapy ◽

Differentiated Thyroid Carcinoma ◽

Whole Body ◽

131I Therapy ◽

131I Ablation ◽

Procedure Guidelines ◽

Lower Blood ◽

Higher Sensitivity

SummaryThe procedure guideline for radioiodine therapy (RIT) of differentiated thyroid cancer (version 3) is the counterpart to the procedure guideline for 131I whole-body scintigraphy (version 3) and specify the interdisciplinary guideline for thyroid cancer of the Deutsche Krebsgesellschaft concerning the nuclear medicine part. Recommendation for ablative 131I therapy is given for all differentiated thyroid carcinoma (DTC) >1 cm. Regarding DTC ≤1 cm 131I ablation may be helpful in an individual constellation. Preparation for 131I ablation requires low iodine diet for two weeks and TSHstimulation by withdrawal of thyroid hormone medication or by use of recombinant human TSH (rhTSH). The advantages of rhTSH (no symptoms of hypothyroidism, lower blood activity) and the advantages of endogenous TSHstimulation (necessary for 131I-therapy in patients with metastases, higher sensitivity of 131I whole-body scan) are discussed. In most centers standard activities are used for 131I ablation. If pretherapeutic dosimetry is planned, the diagnostic administration of 131I should not exceed 1–10 MBq, alternative tracers are 123I or 124I. The recommendations for contraception and family planning are harmonized with the recommendation of ATA and ETA. Regarding the best possible protection of salivary glands the evidence is insufficient to recommend a specific setting. To minimize the risk of dental caries due to xerostomia patients should use preventive strategies for dental hygiene.

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RETROSPECTIVE ANALYSIS OF THE COURSE OF THYROID CARCINOMA WITH LUNG METASTASES AFTER RADIOIODINE THERAPY

Periódico Tchê Química ◽

10.52571/ptq.v17.n35.2020.62_astapieva_pgs_728_738.pdf ◽

2020 ◽

Vol 17 (35) ◽

pp. 728-738

Author(s):

Olha M. ASTAPIEVA ◽

Ganna V. GRUSHKA ◽

Olga I. PASKEVYCH ◽

Yuliia Ya. FEDULENKOVA ◽

Oleksii V. MAKSIMISHYN

Keyword(s):

Thyroid Carcinoma ◽

Disease Progression ◽

Radioiodine Therapy ◽

Clinical Laboratory ◽

Malignant Tumors ◽

Lung Metastases ◽

Survival Rates ◽

Differentiated Thyroid Carcinoma ◽

Thyroid Tumor ◽

Medical Radiology

Metastasis of malignant tumors are one of the most acute problems of oncology. Among the organs and systems of the human body in terms of frequency of damage, one of the first places is occupied by the lungs, which is probably closely related to the anatomical features of their structure and physiology. During the first examination of cancer patients, metastases in the lungs are revealed in 6-15%, lymphogenous metastases are observed in 50-81%. With differentiated thyroid carcinoma (thyroid gland), metastases in the lung are most often detected (up to 15% of cases). At the same time, 5- and 10-year survival rates are 50-92.6% and 42-86%, respectively. The use of 131I-sodium iodide is central to the treatment of these patients. The purpose of the paper is to study the effectiveness of radioiodine therapy for metastases of thyroid carcinoma in the lung. We used clinical, laboratory, radiological methods for the diagnosis of thyroid carcinoma and pulmonary metastases. From 1986 to 2010, 68 patients from the clinic of the S.P. Hryhoriev Institute of Medical Radiology of the Academy of Medical Sciences of Ukraine were included in the study. Lung metastases were found in patients with all stages of the disease and with diverse sizes of the primary thyroid tumor. After the surgical treatment of patients, 131Isodium iodide was used in various doses of radioactivity. The full therapeutic effect of radiotherapy was achieved in 5 patients (7.8%) over a 3-year period of treatment, and a 5-year period – in 28 (43.8%); stabilization or partial effect was noted in 24 patients (37.8%), disease progression was observed in 12 patients (17.6%). Mortality from disease progression was 12.5%.

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Management of papillary and follicular (differentiated) thyroid carcinoma - an update

Bangladesh Journal of Otorhinolaryngology ◽

10.3329/bjo.v16i2.6848 ◽

1970 ◽

Vol 16 (2) ◽

pp. 126-130

Author(s):

Md Abdul Mobin Choudhury ◽

Md Abdul Alim Shaikh

Keyword(s):

Thyroid Cancer ◽

Total Thyroidectomy ◽

Differentiated Thyroid Cancer ◽

Radioiodine Therapy ◽

Endemic Goiter ◽

Follicular Carcinoma ◽

Differentiated Thyroid Carcinoma ◽

Thyroid Cancers ◽

Surgical Options ◽

Definitive Management

Thyroid cancers are quite rare, accounting for only 1.5% of all cancers in adults and 3% of all cancers in children. Differentiated thyroid cancer comprises 95% of all thyroid cancers. Of all thyroid cancers 74-80% of cases are papillary cancers. Incidences of follicular carcinoma are higher in regions where incidence of endemic goiter is high. Surgery is the definitive management of thyroid cancer. There is agreement that patients with large, locally aggressive or metastatic differentiated thyroid cancer require total thyroidectomy but there is continuing disagreement on the most appropriate operation for 'low risk' differentiated thyroid cancer. Adjuvant treatments are thyroid hormone suppression and radioiodine therapy rather than chemotherapy and radiotherapy. Prognosis is generally excellent and is influenced by factors related to the patient, the disease and the therapy. This article reviews the basis of surgical treatment of differentiated thyroid cancer and assesses the evidences supporting the surgical options. Key words: Papillary Carcinoma; Follicular Carcinoma; Hemithyroidectomy; Total Thyroidectomy DOI: 10.3329/bjo.v16i2.6848Bangladesh J Otorhinolaryngol 2010; 16(2): 126-130

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Thyroid Tumor Board: The Pathologic Criteria of Poorly Differentiated Thyroid Cancer Can Be Difficult to Distinguish From Differentiated Thyroid Carcinoma

Clinical Thyroidology ◽

10.1089/ct.2017;29.244-246 ◽

2017 ◽

Vol 29 (6) ◽

pp. 244-246

Author(s):

Brice L. Hunt ◽

Wendy Sacks

Keyword(s):

Thyroid Cancer ◽

Thyroid Carcinoma ◽

Differentiated Thyroid Cancer ◽

Differentiated Thyroid Carcinoma ◽

Thyroid Tumor ◽

Tumor Board ◽

Poorly Differentiated

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The Efficacy of Thyrotropin Suppression Therapy in Treatment of Differentiated Thyroid Cancer after Total Thyroidectomy

Forum of Clinical Oncology ◽

10.1515/fco-2015-0010 ◽

2015 ◽

Vol 6 (2) ◽

pp. 24-33

Author(s):

Niveen A. Abo-Touk ◽

Dalia H. Zayed

Keyword(s):

Thyroid Cancer ◽

High Risk ◽

Thyroid Carcinoma ◽

Differentiated Thyroid Cancer ◽

Tumour Size ◽

Differentiated Thyroid Carcinoma ◽

Tsh Suppression ◽

Significant Difference ◽

Tsh Suppression Therapy ◽

Disease Free

AbstractBackground: The aim of this prospective study was to assess the effect of the TSH suppression on both disease-free and overall survivals in patients with nonmetastatic differentiated thyroid cancer (DTC) after total thyroidectomy.Patients & Methods: One hundred and forty eight patients with pathologically proved operable differentiated thyroid carcinoma were enrolled in this prospective study. Levothyroxin (L-T4) therapy was started in doses according to treatment groups. Patients were randomly assigned to receive either postoperative TSH suppression therapy in group I (76 patients) or nonsuppression therapy in group II (72 patients).Results: During the period of follow up with a median 54 months, the disease-free survival for patients without TSH suppression therapy did not reach statistically significant difference comparing with those for patients with the suppression therapy (p=0.09). However, the difference was statistically significant for high-risk patients (p=0.04). On comparing both groups there was no statistically significant difference with regard to overall survival (p=0.17). The age of the patients more than 45 years, tumour size more than 4 cm and high-risk group were significant independent predictors for thyroid carcinoma-related relapse in univariate analysis. However, tumour size was the only significant factor in multivariate analysis.Conclusion: Suppressive treatment with L-T4 therapy in patients with differentiated thyroid carcinoma should be individualised and balanced against the adverse effects. TSH suppression is indicated in patients with high-risk disease or recurrent tumour. Normalisation of serum TSH is preferred for long-term treatment of disease-free elderly patients with DTC and comorbidities.

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Cumulative doses of radioiodine in the treatment of differentiated thyroid carcinoma: knowing when to stop

Arquivos Brasileiros de Endocrinologia & Metabologia ◽

10.1590/s0004-27302010000900006 ◽

2010 ◽

Vol 54 (9) ◽

pp. 807-812 ◽

Cited By ~ 6

Author(s):

Raul Martins-Filho ◽

Laura S. Ward ◽

Barbara J. Amorim ◽

Allan O. Santos ◽

Mariana C. L. de Lima ◽

...

Keyword(s):

Thyroid Cancer ◽

Thyroid Carcinoma ◽

Differentiated Thyroid Cancer ◽

Progressive Disease ◽

Treatment Strategies ◽

Differentiated Thyroid Carcinoma ◽

Tumor Node Metastasis ◽

Node Metastasis ◽

The Impact

OBJECTIVE: Evaluate the efficacy of cumulative doses (CDs) of 131I-iodide therapy (RIT) in differentiated thyroid cancer (DTC). SUBJECTS AND METHODS: The probability of progressive disease according to CDs was evaluated in patients < 45 years old and > 45 years old and correlated to tumor-node-metastasis (TNM), thyroglobulin values, histological types and variants, age, and zduration of the disease. RESULTS: At the end of a follow-up period of 69 ± 56 months, 85 out of 150 DTC patients submitted to fixed doses RIT had no evidence of disease, 47 had stable disease and 18 had progressive disease. Higher CDs were used in the more aggressive variants (p < 0.0001), higher TNM stages (p < 0.0001), and follicular carcinomas (p = 0.0034). Probability of disease progression was higher with CDs > 600 mCi in patients > 45 years old and with CDs > 800 mCi in patients < 45 years. CONCLUSION: Although some patients may still respond to high CDs, the impact of further RIT should be carefully evaluated and other treatment strategies may be warranted.

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