Treatment of thyroid remnants with 131I in a patient with papillary thyroid carcinoma and end-stage chronic renal failure

Andrés, A.; Tardín, L.; Santapau, A.; Razola, P.; Prats, E.; Parra, A.; Rivas, M.A.; Ruiz, P.; Álvarez, R.C. González; Camara, A.; Banzo, J.

doi:10.1016/s1578-200x(10)70005-x

Cited by 1 publication

(2 citation statements)

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“…At the same time the procedures of pre-therapeutic dosimetry are complex and time-consuming (11,15,16,20). Some pharmacokinetic studies have addressed the fate of 131 I in renally-insufficient patients, however they were focused on patients receiving dialysis (2,5,14,31). To the best of our knowledge, thus far no studies have investigated the mathematical relationship between t 1/2 biol and eGFR in patients with mild to severe renal insufficiency not requiring dialysis.…”

Section: Discussionmentioning

confidence: 99%

“…To date, pharmacokinetic studies with 131 I have been conducted only in patients with terminal renal insufficiency requiring continuous peritoneal dialysis (14,31) or haemodialysis (1,2,22,23). For patients with chronic renal insufficiency stage 2 to 5 (i.e., without dialysis, according to Kidney Disease Outcomes Quality Initiative (KDOQI)), the Procedure guidelines for radioiodine therapy of differentiated thyroid cancer issued by the German Society of Nuclear Medicine do not provide specific recommendations on dose adaptation (6), although they state that renal function and differential blood count must be checked in any patients undergoing radioiodine therapy (6).…”

Section: Zusammenfassungmentioning

confidence: 99%

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Relationship between estimated glomerular filtration rate and biological half-life of 131I

Vogel¹,

Opfermann²,

Wiegand³

et al. 2013

Nuklearmedizin

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Summary Aim: This retrospective study sought to investigate the relationship between biological half-life (t 1/2 biol ) of 131I and estimated glomerular filtration rate (eGFR) in patients with thyroid carcinoma. Patients, methods: 96 patients with differentiated thyroid carcinoma (69 women, 27 men, mean age 64.0 ± 13.6 years) and diagnostic and therapeutic administration of 131I were considered. Patients with pronounced specific iodine storage were not included in the study. The eGFR was estimated according to the Chronic Kidney Disease Epidemiology Collaboration (CKDEPI) formula, the t 1/2 biol via dosimetry. Patients were subdivided in groups with normal clearance (NC) (n = 37, 38.5%), medium clearance (MC) (n = 48, 50.0%), and low clearance (LC) (n = 11, 11.5%) (eGFR _ 90; 60-89; 15-59 ml/min per 1.73 m2, respectively). The relationship between eGFR and t 1/2 biol of 131I was modeled using a power function. Results: The groups significantly differed in terms of age (NC 53.8, MC 68.6, and 78.0 years, respectively), serum creatinine levels (NC: 0.71; MC: 0.85; LC: 1.18 mg/dl), and t 1/2 biol (NC: 0.53; MC: 0.71; LC: 1.01 days). The t 1/2 biol was significantly influenced only by eGFR, and not by age, gender, or body weight. The relationship between t 1/2 biol of 131I and eGFR was described by the formula t 1/2 biol = 20.3 · eGFR−0.782. Conclusions: The calculated relationship between renal function and t 1/2 biol of 131I can be used in principle to estimate a dose reduction for patients with renal insufficiency. The model, however, gives erroneous results in individual cases and therefore a routine utilization cannot be recommended. Prospective studies are necessary, based on larger patient numbers and more accurate methods for dose rate measurement and GFR.

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