A Proposition for the Use of Radioiodine in WDTC Management

Abstract

diagnosed with thyroid cancer at age 45 y or younger; 287 of these reported cycle abnormalities before the diagnosis, and 767 had no cycle abnormalities before the diagnosis. Of these 767 women, 326 received at least 1 radioiodine treatment with 3.7 GBq, and 441 did not. The majority of women were interviewed more than 2 y after radioiodine treatment. The proportion of women who reported cycle abnormalities after thyroid cancer was not significantly higher among women who were treated with 131 I (n 5 34, 10%) than among those who were not treated with 131 I (n 5 41, 9%). In a multivariate logistic regression taking into account year and age at menarche, at diagnosis, and at interview; weight; and smoking habit, we did not observe any increased risk of cycle abnormalities after thyroid cancer among women who had received 131 I therapy (odds ratio, 1.2 [95% confidence interval, 0.7-1.2]).As a final note, we were not able to confirm the results of Souza Rosário et al. (3), who reported transient abnormalities after 131 I therapy. However, our inability to confirm those results may be related to the long delay between treatment and interview in our patients, most of whom were not interviewed until more than 2 y after radioiodine treatment. (1) maintain, the majority of patients are exposed to the risk from radiation for the theoretic benefit of a small minority. Thus, the viewpoint of Hay et al. is consistent with the current fashion. However, their perspective seems somewhat limited to me.They state 3 goals of radioiodine remnant ablation: to increase the specificity of follow-up imaging using radioiodine, to attain undetectable thyroglobulin levels, and to decrease recurrence and increase disease-free survival by eliminating microfoci of carcinoma in the remaining tissue.With regard to the first of these goals, increasing the specificity of follow-up radioiodine imaging, the future does not seem to lie in remnant ablation (which has other purposes) but in the use of SPECT/ CT (2) or, especially and most recently with 124 I, PET/CT (3). These techniques may differentiate remnants from lymph nodes, and the sensitivity will increase substantially with the positron emitter isotope. In so doing, I agree that ablation of the remnant might be avoided, but postoperative metabolic imaging of the remnants and other iodine-avid metastatic foci must be applied and refined.I do not completely agree with the authors when they report that ''the administration of therapeutic 131 I without preceding scintigraphy to identify the target'' is a ''refinement in patient management.'' Although omitting scintigraphy before therapy may simplify management, in my opinion it does not represent progress. Postoperative and pretherapeutic imaging (as well as posttherapeutic imaging) also identify locoregional iodine-avid lesions (lesions in the nodes, indicating the need for repeated surgery) or distant iodine-avid lesions (metastatic lesions, which can be treated other than by radioiodine). When properly applied, pretherapeutic imagings also ...

Downregulation of LSD1 suppresses the proliferation, tumorigenicity and invasion of papillary thyroid carcinoma K1 cells

“…RAI ablation has been used routinely, particularly in low-risk patients with thyroid cancer, for >30 years (13). However, previous studies have suggested that RAI confers only a minor benefit in reducing the risk of recurrence or mortality (14,15). Considerable studies concerning oncogenic genetic alterations have been performed in thyroid cancer (16)(17)(18).…”