Factors Associated with Dose Determination of Radioactive Iodine Therapy for Differentiated Thyroid Cancer

Hong, Chae Moon; Ahn, Byeong‐Cheol

doi:10.1007/s13139-018-0522-0

Cited by 15 publications

(21 citation statements)

References 67 publications

(102 reference statements)

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“…In patients with RAI-avid metastatic disease, RaIT remains the treatment of choice [3], providing a favorable impact on overall survival and disease-free survival [73][74][75][76]. The administered RAI activity can be determined empirically or based on a dosimetric approach [72,77,78]. The empiric approach uses a fixed activity (i.e., 3.7-11.1 GBq), which is selected based on disease stage, age, burden of disease, and kidney function [61].…”

Section: Metastatic Dtc Patientsmentioning

confidence: 99%

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Personalized management of differentiated thyroid cancer in real life – practical guidance from a multidisciplinary panel of experts

et al. 2020

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Purpose The standard of care for differentiated thyroid carcinoma (DTC) includes surgery, risk-adapted postoperative radioiodine therapy (RaIT), individualized thyroid hormone therapy, and follow-up for detection of patients with persistent or recurrent disease. In 2019, the nine Martinique Principles for managing thyroid cancer were developed by the American Thyroid Association, European Association of Nuclear Medicine, Society of Nuclear Medicine and Molecular Imaging, and European Thyroid Association. In this review, we present our clinical practice recommendations with regard to implementing these principles in the diagnosis, treatment, and long-term follow-up of patients with DTC. Methods A multidisciplinary panel of five thyroid cancer experts addressed the implementation of the Martinique Principles in routine clinical practice based on clinical experience and evidence from the literature. Results We provide a suggested approach for the assessment and diagnosis of DTC in routine clinical practice, including the use of neck ultrasound, measurement of serum thyroid-stimulating hormone and calcitonin, fine-needle aspiration, cytology, and molecular imaging. Recommendations for the use of surgery (lobectomy vs. total thyroidectomy) and postoperative RaIT are also provided. Long-term follow-up with neck ultrasound and measurement of serum anti-thyroglobulin antibody and basal/stimulated thyroglobulin is standard, with 123/131I radioiodine diagnostic whole-body scans and 18F-fluoro-2-deoxyglucose positron emission tomography/computed tomography suggested in selected patients. Management of metastatic DTC should involve a multidisciplinary team. Conclusions In routine clinical practice, the Martinique Principles should be implemented in order to optimize clinical management/outcomes of patients with DTC.

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Section: Metastatic Dtc Patientsmentioning

confidence: 99%

“…This approach is simple, effective, and widely used in clinical practice. The potential limitations include over-or under-treatment and a hypothetical progressive loss of efficacy after repeated treatment [59,72,[78][79][80].…”

Section: Metastatic Dtc Patientsmentioning

confidence: 99%

Personalized management of differentiated thyroid cancer in real life – practical guidance from a multidisciplinary panel of experts

et al. 2020

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“…Radioactive iodine (RAI) therapy is an integral part of the standard care for differentiated thyroid cancer (DTC) [1]. For DTC patients with intermediate or high risk of recurrence following total thyroidectomy, RAI ablation therapy is recommended [2][3][4]. Moreover, when 131 I used is more than 1.22 GBq (33 mCi) for RAI therapy, which is equivalent to a dose limit of >5mSv, several days of hospitalization in a licensed facility is mandatory [5,6].…”

Section: Introductionmentioning

confidence: 99%

A practical individualized radiation precaution based on the dose rate at release time after inpatient 131I ablation therapy

et al. 2021

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Introduction Retained radioactivity of 131I after ablation therapy largely differs in each patient according to factors including the amount of remnant thyroid tissue, renal function, and use of recombinant human thyroid-stimulating hormone. To reduce unnecessary restriction of patient’s daily life after inpatient 131I ablation therapy, we propose a practical individualized method for radiation precaution based on dose rate at release time. Methods We evaluated 215 patients with differentiated thyroid cancer who underwent inpatient 131I ablation therapy following total thyroidectomy. Effective dose equivalent rates at 1-m distance were measured upon release (EDRR) on day 2 and during delayed whole-body scan (EDRD) visits on day 6‒8 after 131I administration. The biexponential model was designed to estimate total effective dose equivalent to others. To assess conservativeness of our model, EDRD estimated by our model was compared with measured EDRD. EDRR-based periods of precaution not to receiving 1 mSv of radiation exposure were estimated and compared with those based on administered radioactivities on American Thyroid Association (ATA) recommendations. Results The EDRR ranged from 1.0–48.9 μSv/hr. The measured EDRD were equal to or lower than estimated EDRD in all patients, except for one, indicating that our model is sufficiently conservative. According to our model, no subjects needed additional daytime restriction after release. The maximum permissible times for public transportation use were longer in all patients compared with those based on administered radioactivities. Nighttime restriction periods were significantly shorter than those based on administered radioactivity; median periods requiring sleeping apart were 0 (range, 0‒5), 4 (range, 1‒14), and 3 (range, 2‒13) days after release in patients treated with radioactivity doses of 2.96, 5.50, and 7.40 GBq, respectively, needing 8, 16, and 19 additional days, respectively, based on administered radioactivity. Conclusions Radiation safety instructions using proposed method based on EDRR of individual patient could safely reduce the burden of radiation precaution.

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“…The incidence of thyroid cancer has progressively increased worldwide [1,2]. Following total thyroidectomy for differentiated thyroid cancer (DTC), radioiodine therapy (RIT) is widely used for remnant ablation, adjuvant treatment, or the treatment of persistent or recurrent disease [3]. Although radioiodine contributes to DTC treatment, the potential risk of developing secondary cancer after treatment has emerged as a concern because of the otherwise relatively good survival rates for DTC.…”

Section: Introductionmentioning

confidence: 99%

Factors associated with the development of secondary cancers after radioiodine therapy in differentiated thyroid cancer: A multicenter retrospective study

Hong

Shin

Kim

et al. 2021

Preprint

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Purpose The objective of this study was to estimate the incidence of secondary cancers and the factors associated with their development among patients who underwent radioiodine therapy (RIT) with differentiated thyroid cancer. Methods We retrospectively collected medical records for patients who underwent first RIT between January 1, 2000 and December 31, 2005 from seven tertiary hospitals in South Korea after total thyroidectomy for differentiated thyroid cancer. Cancer incidence and calculated standardized rate ratio was compared with Korean cancer incidence data. The association between the development of secondary cancers and various parameters was analyzed by Cox-proportional hazard regression. Results A total of 3106 patients were included in this study. Mean age at the time of diagnosis of thyroid cancer was 45.7 ± 13.3 years old, and 2669 (85.9%) patients were female. The follow-up period was 11.9 ± 4.6 (range, 1.2–19.6) years. A total of 183 secondary cancers (5.6%), which included 162 solid and 21 hematologic cancers occurred in 173 patients. There was no significant difference between solid cancer incidence in our study population who underwent RIT and the overall Korean population, but the incidence of hematologic cancers and total cancer in our study was significantly higher compared with that of the Korean population. A multivariate analysis identified independent prognostic factors for the development of secondary cancer including age at 1st RIT, male, and total cumulative dose over 200 mCi. Conclusion We need to assess the risk benefit for patients who receive over 200 mCi of a total cumulative dose.

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Factors Associated with Dose Determination of Radioactive Iodine Therapy for Differentiated Thyroid Cancer

Cited by 15 publications

References 67 publications

Personalized management of differentiated thyroid cancer in real life – practical guidance from a multidisciplinary panel of experts

Personalized management of differentiated thyroid cancer in real life – practical guidance from a multidisciplinary panel of experts

A practical individualized radiation precaution based on the dose rate at release time after inpatient 131I ablation therapy

Factors associated with the development of secondary cancers after radioiodine therapy in differentiated thyroid cancer: A multicenter retrospective study

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