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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.

Authors+Show Affiliations

Thyroid Unit, Royal Marsden Hospital, Downs Road, Sutton, Surrey SM2 5PT, United Kingdom.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

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 -