Radioactive iodine in the treatment of medullary thyroid carcinoma: a controlled multicenter study

Meijer, Johannes Arnoldus Anthonius; Bakker, Leontine E. H.; Valk, Gerlof D.; Herder, Wouter W. de; Wilt, Johannes H. W. de; Netea‐Maier, Romana T.; Schaper, Nicolaas C.; Fliers, Eric; Lips, Paul; Plukker, John; Links, Th. P.; Smit, Johannes

doi:10.1530/eje-12-0943

Cited by 40 publications

(37 citation statements)

References 25 publications

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“…In addition, a larger multiinstitutional study of RAI in patients with MTC from the Netherlands included a small subset of patients who underwent prophylactic thyroidectomies (n = 56), and found that none of the nine patients who received RAI developed biochemical or radiologic evidence of MTC, compared to 40% of those who underwent surgery alone. However, the univariate hazard ratio for disease-free survival in these patients was not statistically significant 15 . While it seems clear RAI should not play a role in the treatment of MTC, our findings and those described above suggest further investigation of its role as adjuvant preventative therapy following prophylactic thyroidectomy, weighing the long-term risks of adverse effects including leukemia 16 .…”

Section: Discussionmentioning

confidence: 67%

“…Historically RAI was considered postoperatively in patients with MTC for the theoretical “bystander effect,” which hypothesized that radioactive iodine taken up by thyroid follicular cells would prove toxic to adjacent C cells via β-ray emission. There have been some case reports and small series reporting decreased calcitonin levels in patients with known MTC treated with RAI, in addition to decreased CCH following RAI in animal studies 8-11 ; however, other series have not shown an improvement in outcomes, and a survival benefit has never been demonstrated 12-15 . One recent small study of patients with documented MTC showed a decrease in postoperatively elevated basal and stimulated calcitonin levels after RAI administration in three out of seven treated patients, all of whom had no evidence of lymph node or distant metastases 10 .…”

Section: Discussionmentioning

confidence: 99%

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Utility of serum thyroglobulin measurements after prophylactic thyroidectomy in patients with hereditary medullary thyroid cancer

Seib

Harari

Conte

et al. 2014

Surgery

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Introduction Prophylactic thyroidectomy can be curative for patients with hereditary medullary thyroid cancer (MTC) caused by RET proto-oncogene mutations. Calcitonin is a sensitive tumor marker used to follow patients. We suggest that thyroglobulin (Tg) levels should also be monitored postoperatively in these patients. Methods We reviewed patients with RET mutations who underwent prophylactic thyroidectomy between 1981 and 2011 at an academic endocrine surgery center. Patients were excluded if they had no postoperative Tg levels. Results Of the 22 patients who underwent prophylactic thyroidectomy, 14 were included in final analysis. The average age at thyroidectomy was 9.8 years (range 4 to 29). Tg levels were detectable 1.5 months to 31 years postoperatively in 11 patients (79%), all of whom were younger than 15 years-old at thyroidectomy. Median TSH was 2.5 mIU/L and 13.4 mIU/L in patients with undetectable and detectable Tg, respectively. Of those with detectable Tg, five had neck ultrasounds: Two showed no residual tissue in the thyroid bed, and three showed remnant thyroid tissue. Conclusions Tg levels can identify patients with remnant thyroid tissue after prophylactic thyroidectomy. Ultrasound can determine if thyroid tissue remains posterolaterally and is at risk of MTC recurrence. Maintaining normal TSH may prevent growth of remaining thyroid follicular cells.

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Section: Discussionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Utility of serum thyroglobulin measurements after prophylactic thyroidectomy in patients with hereditary medullary thyroid cancer

Seib

Harari

Conte

et al. 2014

Surgery

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“…131,132 This is attributed to the fact that MTC arises from parafollicular C cells of the thyroid gland, which do not concentrate iodine. 131,132 This is attributed to the fact that MTC arises from parafollicular C cells of the thyroid gland, which do not concentrate iodine.…”

Section: Radionuclide Therapymentioning

confidence: 99%

Multiple Endocrine Neoplasia Type 2 and Medullary Thyroid Carcinoma

Tacon¹,

Learoyd²,

Robinson³

2016

Endocrinology: Adult and Pediatric

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“…If metastases are large and located in areas that are easy to remove, they should be removed surgically Discussion [5,6]. Other treatment options, such as radiation treatment, chemotherapy and embolization, are applied for patients for whom surgery is not an option [7,8].…”

Section: Case Presentationmentioning

confidence: 99%

Fifteen-year treatment of metastatic thyroid medullary carcinoma: a case report

Gül¹,

Cander²,

Sisman³

et al. 2015

Eur Res J

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Medullary thyroid carcinoma (MTC) accounts for 5 to 10% of all thyroid malignancies and shows more aggressive progression than papillary and follicular carcinomas. Average age is approximately 50 years and it is reported that the disease is slightly more common in women. Although the most common initial complaint is painless swelling on the neck, dysphagia, dysphonia and dyspnea may also be seen. It is reported that 75% of MTC cases are sporadic and 25% are familial (multiple endocrine neoplasia type 2A or 2B or isolated familial medullary thyroid cancer).While Ret proto-oncogene mutation is detected in more than 95% of familial medullar cancers, Ret ABSTRACT 160Although very rare, medullary thyroid carcinoma (MTC) is the most aggressive in differentiated thyroid malignancies. We report a 48-year-old male patient with the diagnosis of MTC, who was monitored for fifteen years and showed no serious adverse events due to long-term chemotherapy. Total thyroidectomy, neck dissection, retrosternal nodule excision and pericardiectomy were performed, and radiotherapy was applied to the neck area. Due to progressive metastatic disease cyclophosphamide, dacarbazine, and vincristine were administrated. He tolerated chemotherapy well, and no severe systemic side effects were detected. He died due to multi-organ failure after fifteen years of diagnosis. The only curative treatment is surgery in MTC, however; radiotherapy, chemotherapy, and embolization may be used for patients for whom surgery cannot be performed. Although success rates of systemic chemotherapy are low, it is a treatment option in the progressive metastatic disease.

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Radioactive iodine in the treatment of medullary thyroid carcinoma: a controlled multicenter study

Cited by 40 publications

References 25 publications

Utility of serum thyroglobulin measurements after prophylactic thyroidectomy in patients with hereditary medullary thyroid cancer

Utility of serum thyroglobulin measurements after prophylactic thyroidectomy in patients with hereditary medullary thyroid cancer

Multiple Endocrine Neoplasia Type 2 and Medullary Thyroid Carcinoma

Fifteen-year treatment of metastatic thyroid medullary carcinoma: a case report

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