Short-term outcome of differentiated thyroid cancer patients receiving a second iodine-131 therapy on the basis of a detectable serum thyroglobulin level after initial treatment
Short-term outcome of differentiated thyroid cancer patients receiving a second iodine-131 therapy on the basis of a detectable serum thyroglobulin level after initial treatment
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DOI：
10.1007/s00259-005-1929-2
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发表时间：
2006-02-01
影响因子：
9.1
通讯作者：
Salvatore, M
中科院分区：
文献类型：
--
作者：
Pace, L;Klain, M;Salvatore, M
Purpose: The aim of this study was to evaluate the usefulness of high-dose I-131 therapy administered only on the basis of raised serum Tg levels.Methods: Among patients treated with total or near-total thyroidectomy and I-131 ablation, 76 ( 54 women and 22 men) with differentiated thyroid cancer ( 41 with follicular and 35 with papillary cancer) showed a detectable (i.e. > 1.5 ng/ml) serum Tg level on L-thyroxine therapy during follow-up and were included in the study. In these patients, a further I-131 therapy was scheduled ( range 3.7 - 9.25 GBq, mean 6.087 +/- 1.705). Five to seven days after this radioiodine therapy, patients underwent 131I post-therapy whole-body scan (I-131 t-WBS). The serum Tg value at 12 months after I-131 therapy was evaluated as an indicator of short-term response to radioiodine.Results: At evaluation after 12 months, 21 (27.6%) of the 76 patients had a Tg value = 50% decrease in the Tg. Of the 52 patients of group A, 19 (36%) had local recurrence at I-131 t-WBS, 18 (35%) showed lung involvement and 15, ( 29%) bone metastasis. On a patient basis, two (13%) of 15 patients with bone metastases, six (33%) of 18 patients with lung involvement and seven (37%) of 19 patients with local recurrence had Tg values at follow-up of = 50% decrease in Tg.Conclusion: The findings of the present study suggest that the administration of therapeutic I-131 only on the basis of elevated Tg levels has a definite therapeutic effect, at least in the short term. In addition, the possibility of obtaining a post-therapeutic I-131 WBS can lead to better strategy definition for these patients.
