Intermediate and long-term adverse effects of radioiodine therapy for differentiated thyroid carcinoma – A systematic review

Clément, Sarah; Peeters, Robin P.; Ronckers, Cécile M.; Links, Thera P.; Heuvel‐Eibrink, Marry M. van den; Dijkum, Els J. M. Nieveen van; Rijn, Rick R. van; Pal, Heleen J H van der; Neggers, Sebastian J C M M; Kremer, Leontien C. M.; Eck-Smit, Berthe L. F. van; Santen, Hanneke M van

doi:10.1016/j.ctrv.2015.09.001

Cited by 132 publications

(93 citation statements)

References 38 publications

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“…Similarly, another study, concluded that although high I-131 activities used in the first application are significantly more effective in thyroid ablation than low-and intermediate activities, it is not the case in re-ablation [14]. Long-term side effects, including the possibility for secondary malignancies, as well as increased radiation exposure to medical staff, must be taken into consideration when using high activities [17,18]. Furthermore, when high activity I-131 is applied, the patient has to be hospitalized on two occasions.…”

Section: Discussionmentioning

confidence: 99%

Re-ablation I-131 activity does not predict treatment success in low- and intermediate-risk patients with differentiated thyroid carcinoma

Prpić¹,

Kruljac

Kust³

et al. 2016

Endocrine

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Results: Re-ablation was successful in 113 out of 128 patients (88.3%). Mean first I-131 activity was 2868 ± 914 MBq (77.5 ± 24.7 mCi), and mean second I-131 activity 3004 ± 699 MBq (81.2 ± 18.9 mCi). There was no association between the first, second, and cumulative activity with reablation treatment outcome. Treatment failure was associated with higher Tg levels prior to reablation (Tg2) (OR 1.16, 95% CI 1.05 -1.29, P=0.003) and N1a status (OR 3.89, P=0.032). After excluding patients with positive-to-negative TgAb conversion, Tg2 level of 3.7 ng/mL predicted treatment failure with a sensitivity of 75.0 %, specificity of 80.5%, and a negative predictive value of 97.1%. Patients with positive-to-negative TgAb conversion had higher failure rates (OR=2.96, 95% CI 0.94 -9.29).3 Conclusions: Re-ablation success was high in all subgroups of patients and I-131 activity did not influence treatment outcome. Tg may serve as a good predictor of re-ablation failure. Patients with positive-to-negative TgAb conversion represent a specific group, in whom Tg level should not be used as a predictive marker of treatment outcome.

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Section: Discussionmentioning

confidence: 99%

Re-ablation I-131 activity does not predict treatment success in low- and intermediate-risk patients with differentiated thyroid carcinoma

Prpić¹,

Kruljac

Kust³

et al. 2016

Endocrine

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“…Clemens et al performed a systemic review of the literature to examine the risk of intermediate and long-term adverse effects of iodine-131 therapy in differentiated thyroid cancer patients [1]. Their work included 37 studies.…”

Section: Open Access Peer-reviewedmentioning

confidence: 99%

“…hyroid cancer is the most commonly diagnosed endocrine tumor and the incidence in thyroid cancer is rising throughout the world [1,2]. The therapy of thyroid cancer consists of thyroidectomy, thyroid hormone treatment and, depending on pathological stage, postsurgical radioactive iodine ablation (RIA).…”

mentioning

confidence: 99%

“…The therapy of thyroid cancer consists of thyroidectomy, thyroid hormone treatment and, depending on pathological stage, postsurgical radioactive iodine ablation (RIA). Because of the excellent prognosis of differentiated thyroid cancer (DTC) and the fact that radiation exposure represents a risk factor for many other cancers, in the last years there has been an exponential attention to the possible association between RIA and second malignancies in thyroid cancer patients [1][2][3][4][5][6][7][8][9].…”

mentioning

confidence: 99%

“…In this commentary, we would like to briefly critically review the results of some of the more recent studies and expose our personal perspective. Several studies, comprehensive reviews and at least three meta-analyses on the association between RIA and second cancers have been published in the last years [1][2][3][4][5][6][7][8][9]. To express our consideration we will select some representative papers of these.…”

mentioning

confidence: 99%

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Incidence of Second Cancers in Thyroid Cancer Patients Treated with Radioactive Iodine Ablation: How High Is Really the Risk?

Giovacchini¹,

Leoncini²

2016

J Diagn Imaging Ther

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Differentiated thyroid cancer (DTC) is a common endocrine tumor with increasing incidence and excellent prognosis. The therapy of thyroid cancer consists of thyroidectomy, thyroid hormone treatment and, depending on pathological stage, adjuvant radioactive iodine ablation (RIA). Because of the excellent outcome of DTC and the potential cancerous effect of iodine-131, in the last years there has been a huge number of articles addressing the issue of the incidence of second tumors in DTC patients. We will make a short critical review of some of these articles focusing on results reporting and interpretation. Methodological factors that may affect the obtained results will be highlighted for the benefit of the reader so that the risk associated to iodine-131 exposure will be balanced to the risk associated to other risk factors, including enhanced medical surveillance, shared genetic variability and environment factors and proper methodological study design. The review is finally a call to physicians involved in the therapy of these patients, primarily nuclear medicine physicians, endocrinologists and surgeons, to join their complimentary skill for the therapy of these patients.

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Salivary side effects after radioiodine treatment for differentiated papillary thyroid carcinoma: Long‐term study

et al. 2020

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Background: Although many studies focus on short-term side effects of radioiodine therapy, almost none studied long-term side effects. We assessed radioiodine long-term salivary side effects after radioiodine treatment for differentiated papillary thyroid carcinoma and compared it to short-term morbidity within the same population. Methods: A standardized self-administrated questionnaire was submitted in 2019 by patients treated with radioiodine between January 2011 and December 2012. These patients had already answered the same questionnaire 6 years before. Results: Our study showed a significant reduction for salivary side effects: discomfort in submandibular or parotid area, swelling, pain, a bad or salty taste in the mouth, allowing to get back to a "normal" diet. Conclusions: Our study suggests that a significant rate of patients will recover from I 131 therapy salivary side effects. As almost 30% of these remissions happened during our late stage follow-up, we highlight the necessity of a longterm follow-up in these patients.

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Intermediate and long-term adverse effects of radioiodine therapy for differentiated thyroid carcinoma – A systematic review

Cited by 132 publications

References 38 publications

Re-ablation I-131 activity does not predict treatment success in low- and intermediate-risk patients with differentiated thyroid carcinoma

Re-ablation I-131 activity does not predict treatment success in low- and intermediate-risk patients with differentiated thyroid carcinoma

Incidence of Second Cancers in Thyroid Cancer Patients Treated with Radioactive Iodine Ablation: How High Is Really the Risk?

Salivary side effects after radioiodine treatment for differentiated papillary thyroid carcinoma: Long‐term study

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