Radioiodine-remnant ablation in low-risk differentiated thyroid cancer: pros

Abstract

Differentiated thyroid carcinomas are typically treated with total thyroidectomy as initial therapy. Subsequent radioactive iodine (RAI) ablation destroys post-surgical thyroid remnants, can additionally provide adjuvant therapy of residual and metastatic thyroid cancers, and enhances the sensitivity and specificity of further diagnostic studies. There is current controversy regarding whether a large number of patients, broadly considered to have "low-risk" disease, should be provided RAI ablation. This is consequent to over-reliance on short-term studies, under-appreciation of the value of RAI remnant ablation, and inflation of the side effects of RAI therapy. A balanced assessment of all of these issues provides justification to utilize post-surgical radioiodine ablation, even in cases that are considered low risk on the basis of surgical findings.

Clinical outcomes and associated factors of radioiodine-131 treatment in differentiated thyroid cancer with cervical lymph node metastasis

“…The first sufficient dose of 131 I administration following thyroidectomy to eradicate the remnant normal thyroid tissue is termed 'remnant ablation' (8). The goal of remnant ablation is to achieve an undetectable serum thyroglobulin (Tg) level, which serves as a tumor marker to facilitate follow-up of biochemical analysis, to eradicate any neoplastic foci to decrease the risk of recurrence and to detect any recurrence by 131 I scanning (9).…”

Re-ablation I-131 activity does not predict treatment success in low- and intermediate-risk patients with differentiated thyroid carcinoma

“…Patients with low-and intermediate-risk differentiated thyroid carcinoma (DTC) are selectively treated with postoperative radioactive iodine (I-131) ablation; however, the indication for I-131 therapy is the subject of an ongoing debate, and there is no consensus regarding optimal I-131 activity in this group of patients [1][2][3][4][5][6][7]. Following a single application of I-131, approximately 8-40% of patients require an additional application (re-ablation) due to ablation failure.…”

Combined treatment of the highly differentiated cancer of thyroid gland: recombinant human thyrotropin-alpha is in the focus

“…В обох групах проведено аналіз показників якості життя за допомогою адаптованої російсько-та україномовної версії опитувальника «The University of Sãn Paulo Quality of Life Protocol after Thyroidectomy», розроблений професором C. R. Cernea (Бразилія, Університет м Сан Пауло) [16].…”

“…Крім того, на наш погляд, який збігається з думкою інших дослідників, суттєвою перевагою ви-користання рлТТГ є суттєве зниження впливу раді-оактивної речовини на організм вцілому, оскільки концентрація 131 I в тканини-мішені не знижується, а кліренс радіойоду зростає на 50 % [17,18].…”