Treatment of advanced differentiated thyroid carcinoma with high activity radioiodine therapy

Abstract

Repeated treatment with high activity (9 GBq) I in patients with advanced differentiated thyroid carcinoma appears to be of no apparent benefit and may lead to late morbidity.

Dosimetry and thyroid cancer: the individual dosage of radioiodine

“…Normally, the activity is limited for safety reasons to around 7.4 GBq. A summary on the use of fixed activities for the treatment of DTC until 2002 can be found in a review article by Menzel et al (1996), Van Nostrand et al (2002) and Haq et al (2004) adopt a more aggressive approach for advanced stages of the disease employing empiric fixed activities of radioiodine of 9 GBq (Haq et al 2004) and 11.1 GBq at 3-month intervals (Menzel et al 1996).…”

Unexpected Effect of Furosemide on Radioiodine Urinary Excretion in Patients with Differentiated Thyroid Carcinomas Treated with Iodine 131

“…T herapeutic administration of the iodine isotope 131 I for ablation of postsurgery thyroid remnants, or for the treatment of local regrowth and=or local and distant metastases, is the usual procedure in the management of the majority of patients with differentiated thyroid cancer (DTC) (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11).…”

Preparing Patients for Radioiodine Treatment: Increasing Thyroid Cell Uptake and Accelerating the Excretion of Unbound Radioiodine

“…It is a regular segment of the standard therapeutic procedure in differentiated thyroid carcinoma treatment and it comes recommended by a number of authorities in the field Dietlein et al, 2007;Luster et al, 2008;National Comprehensive Cancer Network [NCCN], 2010;). Certain differences in opinion on the subject are concerned only with the dose that is applied, as well as with whether radioactive iodine therapy should be utilized in lower risk patients (ȃ а ая&Ша , 1981;Haq et al, 2004;Ringel&Ladenson, 2004;Cooper et al, 2006;Pacini et al, 2006;Gheriani, 2006). Several decades of experience have shown indisputable beneficial effects of the administration of 131 I as postoperative adjuvant therapy.…”

“…In cases of differentiated thyroid carcinoma treatment the doses of 131 I vary from 30mCi for the remaining thyroid tissue ablation, to 200 mCi for the treatment of metastases, even though there are several records of the doses reaching as much as 333 mCi (9GBq) (Haq et al, 2004). With the application of these larger doses, the permitted radioactivity limit in the body is reached a few days following the application of the ablation/therapeutic dose of 131 I (Venencia et al, 2002).…”