Clinico-social factors to choose radioactive iodine dose in differentiated thyroid cancer patients

Abstract

Different RAI dose ranges are used in the low-risk group probably because the enrolled physicians consider RAI dose elevation on the basis of clinico-social factors beyond pre-existed guidelines. Our study may enable closer harmonization of RAI therapy practice in Asian countries.

The efficacy of radioactive iodine for the treatment of well-differentiated thyroid cancer with distant metastasis

“…A recent Asian survey showed that different 131 I dose ranges were used in patients with low-risk thyroid cancer, which was probably because the enrolled physicians considered 131 I dose elevation on the basis of clinicosocial factors that were beyond the pre-existing guidelines 17. Postoperative high serum Tg level, inadequate information on lymph node involvement, and histopathology reporting were the major factors for elevated 131 I dose.…”

“…Postoperative high serum Tg level, inadequate information on lymph node involvement, and histopathology reporting were the major factors for elevated 131 I dose. There remains no consensus on the dose and timing of 131 I for patients with thyroid cancer after thyroidectomy 17–20. In contrast, low-dose 131 I ablation was not found to produce significantly different responses or long-term outcomes in patients with small papillary thyroid carcinomas who had microscopic extrathyroid extensions and cervical lymph node metastases 19.…”

Optimization of serum thyroglobulin measured at different time points for prognostic evaluation in differentiated thyroid carcinoma patients

“…Many experts have recommended serum Tg for RAI dose selection. [ 10 ] To fix a RAI dose group, Jin et al compared the adjusted dose group with respect to iodine uptake and serum Tg level. [ 22 ] They demonstrated that the successful response rate was significantly higher in the adjusted group, although the administered dose and side effects such as xerostomia, were significantly lower compared with the fixed dose group.…”

“…Serum Tg has been studied as one of the significant factors in RAI dose selection. [ 10 ] However, rhTSH-stimulated Tg, measured just before RAI therapy, is limited as a practical tool in the selection of an appropriate RAI dose, and serum Tg evaluated at an earlier time point is necessary, considering the time interval between ordering RAI after dose selection and arrival at the hospital.…”

Comparison of I-131 Biokinetics after Recombinant Human TSH Stimulation and Thyroid Hormone Withdrawal Measured by External Detector in Patients with Differentiated Thyroid Cancer

“…Ablation of remnant thyroid tissue by administration of radioactive iodine (I-131) after total thyroidectomy is a safe and effective treatment in patients with differentiated thyroid cancer (DTC), which provides a better prognosis and reliable follow-ups for DTC patients by measuring serum thyroglobulin (Tg) 123456. Successful ablation is usually defined as no visible uptake in the thyroid bed in diagnostic scan or, if visible, a percentage uptake <0.1%, 6–8 months after radioiodine therapy, and/or a stimulated serum Tg concentration <1 ng/mL 7.…”