Radioiodine as an adjuvant therapy and its role in follow-up of differentiated thyroid cancer

Padma, S; Sundaram, P Shanmuga

doi:10.4103/0973-1482.163677

Cited by 7 publications

(1 citation statement)

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“…Clinical observations reveal that a significant number of intermediate-risk DTC patients display persistent small-volume structural disease or abnormal postoperative thyroglobulin values, indicating the persistence of disease (12). Studies suggest that adjuvant therapy can have beneficial effects in up to 30% of DTC patients by destroying potentially malignant cells or occult multifocal disease (13). Research conducted by Ruel et al established a positive correlation between radioactive iodine (RAI) treatment and increased overall survival, noting a 29% reduced risk of death when RAI was administered in the postoperative setting (5).…”

Section: Discussionmentioning

confidence: 99%

Higher adjuvant radioactive iodine therapy dosage helps intermediate-risk papillary thyroid carcinoma patients achieve better therapeutic effect

Li,

Zheng,

et al. 2024

Front. Endocrinol.

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ObjectiveThis retrospective study aims to evaluate the therapeutic effect of varying dosages of adjuvant radioactive iodine (RAI) therapy on intermediate-risk papillary thyroid carcinoma (PTC) patients.MethodsThis retrospective study involved a total of 427 intermediate-risk PTC patients, out of which 202 received a 3.7GBq dosage of RAI, and 225 received a 5.55GBq dosage. The evaluation involved assessing the therapeutic outcomes, number of treatment cycles, and successful remnant ablation rates in both dose groups, six months post-adjuvant RAI therapy. Univariate and multivariate logistic regression analyses were employed to identify factors linked with excellent response (ER). Following this, prognostic nomograms were constructed to provide a visual representation of the prediction models. Calibration curves, the concordance index (C-index), and the receiver operating characteristic (ROC) curve were employed to evaluate the predictive performance of these nomograms. The Hosmer-Lemeshow test was applied to assess the models’ goodness-of-fit. Additionally, the clinical utility of the prognostic nomograms was appraised through decision curve analysis (DCA)ResultsThe high-dose (HD) group exhibited significantly higher proportions of ER, single treatment cycles, and successful remnant ablation rates (p<0.05). Being male, receiving a 3.7GBq dose, having an N1b stage, an sTg level ≥10ng/ml, or an sTg/TSH ratio ≥0.11 were independent risk factors for Non-ER. Two prognostic nomograms, “sTg Nomogram” and “sTg/TSH Nomogram”, were established. The ranking of factors contributing to ER, in descending order, included the sTg or sTg/TSH ratio, N stage, therapy dosage, sex, and soft tissue invasion. The “sTg/TSH Nomogram” demonstrated a higher C-index compared to the “sTg Nomogram”. The calibration curves indicated excellent calibration for both nomograms. DCA demonstrated that the net benefit of the “sTg/TSH Nomogram” was higher than that of the “sTg Nomogram”.ConclusionHigher initial RAI therapy doses can improve therapeutic efficacy for intermediate-risk PTC patients. The developed nomograms, particularly the “sTg/TSH Nomogram”, could assist clinicians in optimal therapeutic decision-making.

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Section: Discussionmentioning

confidence: 99%

Higher adjuvant radioactive iodine therapy dosage helps intermediate-risk papillary thyroid carcinoma patients achieve better therapeutic effect

Li,

Zheng,

et al. 2024

Front. Endocrinol.

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The Role of Nuclear Medicine in Thyroid and Parathyroid Disorders

Sundaram,

Subramanyam,

Dinesh Kumar

2024

Surgical Management of Thyroid and Parathyroid Diseases

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Thyroid cancer management

et al. 2018

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Thyroid nodules are very common, and their frequency is four to five times higher in women than in men. Most of them are benign, with only a very little percentage revealing a malignant neoplasm. About 50% of thyroid nodules are detected by self-palpation of neck, whereas the other 50% are diagnosed by neck ultrasonography and following fine-needle aspiration. Management of thyroid nodules is very difficult, because benign nodules are prevalent, whereas thyroid carcinoma is uncommon, representing only 1% of all malignancies. A standard diagnostic approach is represented by 'first-level' exams, consisting in neck ultrasonography and serum thyroid-stimulating hormone measurement, followed, only for nodules that are suspicious of malignancy, by 'second-level' exams, consisting of fine-needle aspiration and mutational test, which does detect particular DNA mutations present only in malignant cells. In this review, we will analyze the genetics of thyroid cancer and its heterogeneity, and we will briefly describe the current available diagnostic and therapeutic approaches.

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Radioiodine as an adjuvant therapy and its role in follow-up of differentiated thyroid cancer

Cited by 7 publications

References 0 publications

Higher adjuvant radioactive iodine therapy dosage helps intermediate-risk papillary thyroid carcinoma patients achieve better therapeutic effect

Higher adjuvant radioactive iodine therapy dosage helps intermediate-risk papillary thyroid carcinoma patients achieve better therapeutic effect

The Role of Nuclear Medicine in Thyroid and Parathyroid Disorders

Thyroid cancer management

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