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Long-term outcomes following low-dose radioiodide ablation for differentiated thyroid cancer.
J Clin Endocrinol Metab. 2013 May; 98(5):1819-25.JC

Abstract

CONTEXT

Randomized trials show that low-dose (1.1 GBq [30 mCi]) radioiodide (RAI) has efficacy equivalent to high-dose RAI (3.7 GBq [100 mCi]) in thyroid remnant ablation (TRA) for differentiated thyroid cancer. Long-term follow-up is required to ensure detection of late recurrences and to confirm equivalence in terms of survival end points. However, median follow-up duration within randomized trials is currently limited.

PATIENTS AND SETTING

We studied 53 patients undergoing TRA for differentiated thyroid cancer with long-term follow-up in the Thyroid Unit of The Royal Marsden Hospital (Sutton, United Kingdom).

INTERVENTION

Patients were treated with TRA using low-dose (1.1 GBq) RAI.

MAIN OUTCOME MEASURES

Disease-free survival, overall survival, and the incidence of second malignancies were measured. Multivariable analysis was used to determine clinical risk factors for failure to achieve TRA after low-dose RAI.

RESULTS

Median follow-up was 24 (range, 4-34) years. Low-dose RAI TRA was successful in 26 (49%) patients (successful ablation [SA] group), whereas 27 (51%) patients required further treatment (unsuccessful ablation [UA] group). Thirty-year disease-free survival was 92% in the SA group vs 87% in the UA group (P = .601). Thirty-year overall survival was 81% in the SA group vs 62% in the UA group (P = .154). Nine (17%) patients developed second malignancies (4 in the SA group and 5 in the UA group). Predictors of failure to achieve TRA with low-dose RAI were male sex and stage pT4 disease.

CONCLUSIONS

There is no evidence from long-term follow-up of our cohort that treatment outcomes are compromised for patients that fail TRA with low-dose RAI and subsequently receive high-dose RAI.

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Authors+Show Affiliations

Welsh L
Thyroid Unit, Royal Marsden Hospital, Downs Road, Sutton, Surrey SM2 5PT, United Kingdom.
Powell C
No affiliation info available
Pratt B
No affiliation info available
Harrington K
No affiliation info available
Nutting C
No affiliation info available
Harmer C
No affiliation info available
Newbold K
No affiliation info available

MeSH

AdolescentAdultAgedCohort StudiesCombined Modality TherapyFemaleFollow-Up StudiesHumansIodine RadioisotopesMaleMiddle AgedNeoplasm MetastasisNeoplasm Recurrence, LocalNeoplasm StagingProspective StudiesRadionuclide ImagingRadiopharmaceuticalsSex CharacteristicsSurvival AnalysisThyroid NeoplasmsYoung Adult

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23493434

Citation

Welsh, Liam, et al. "Long-term Outcomes Following Low-dose Radioiodide Ablation for Differentiated Thyroid Cancer." The Journal of Clinical Endocrinology and Metabolism, vol. 98, no. 5, 2013, pp. 1819-25.
Welsh L, Powell C, Pratt B, et al. Long-term outcomes following low-dose radioiodide ablation for differentiated thyroid cancer. J Clin Endocrinol Metab. 2013;98(5):1819-25.
Welsh, L., Powell, C., Pratt, B., Harrington, K., Nutting, C., Harmer, C., & Newbold, K. (2013). Long-term outcomes following low-dose radioiodide ablation for differentiated thyroid cancer. The Journal of Clinical Endocrinology and Metabolism, 98(5), 1819-25. https://doi.org/10.1210/jc.2013-1197
Welsh L, et al. Long-term Outcomes Following Low-dose Radioiodide Ablation for Differentiated Thyroid Cancer. J Clin Endocrinol Metab. 2013;98(5):1819-25. PubMed PMID: 23493434.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term outcomes following low-dose radioiodide ablation for differentiated thyroid cancer. AU - Welsh,Liam, AU - Powell,Ceri, AU - Pratt,Brenda, AU - Harrington,Kevin, AU - Nutting,Chris, AU - Harmer,Clive, AU - Newbold,Kate, Y1 - 2013/03/14/ PY - 2013/3/16/entrez PY - 2013/3/16/pubmed PY - 2013/7/6/medline SP - 1819 EP - 25 JF - The Journal of clinical endocrinology and metabolism JO - J Clin Endocrinol Metab VL - 98 IS - 5 N2 - CONTEXT: Randomized trials show that low-dose (1.1 GBq [30 mCi]) radioiodide (RAI) has efficacy equivalent to high-dose RAI (3.7 GBq [100 mCi]) in thyroid remnant ablation (TRA) for differentiated thyroid cancer. Long-term follow-up is required to ensure detection of late recurrences and to confirm equivalence in terms of survival end points. However, median follow-up duration within randomized trials is currently limited. PATIENTS AND SETTING: We studied 53 patients undergoing TRA for differentiated thyroid cancer with long-term follow-up in the Thyroid Unit of The Royal Marsden Hospital (Sutton, United Kingdom). INTERVENTION: Patients were treated with TRA using low-dose (1.1 GBq) RAI. MAIN OUTCOME MEASURES: Disease-free survival, overall survival, and the incidence of second malignancies were measured. Multivariable analysis was used to determine clinical risk factors for failure to achieve TRA after low-dose RAI. RESULTS: Median follow-up was 24 (range, 4-34) years. Low-dose RAI TRA was successful in 26 (49%) patients (successful ablation [SA] group), whereas 27 (51%) patients required further treatment (unsuccessful ablation [UA] group). Thirty-year disease-free survival was 92% in the SA group vs 87% in the UA group (P = .601). Thirty-year overall survival was 81% in the SA group vs 62% in the UA group (P = .154). Nine (17%) patients developed second malignancies (4 in the SA group and 5 in the UA group). Predictors of failure to achieve TRA with low-dose RAI were male sex and stage pT4 disease. CONCLUSIONS: There is no evidence from long-term follow-up of our cohort that treatment outcomes are compromised for patients that fail TRA with low-dose RAI and subsequently receive high-dose RAI. SN - 1945-7197 UR - https://www.unboundmedicine.com/medline/citation/23493434/Long_term_outcomes_following_low_dose_radioiodide_ablation_for_differentiated_thyroid_cancer_ L2 - https://academic.oup.com/jcem/article-lookup/doi/10.1210/jc.2013-1197 DB - PRIME DP - Unbound Medicine ER -
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