Ablation of the thyroid remnant and I-131 dose in differentiated thyroid cancer

Doi, SAR and Woodhouse, NJY (2000) Ablation of the thyroid remnant and I-131 dose in differentiated thyroid cancer. Clinical endocrinology, 52 6: 765-773. doi:10.1046/j.1365-2265.2000.01014.x


Author Doi, SAR
Woodhouse, NJY
Title Ablation of the thyroid remnant and I-131 dose in differentiated thyroid cancer
Journal name Clinical endocrinology   Check publisher's open access policy
ISSN 0300-0664
1365-2265
Publication date 2000-06
Sub-type Article (original research)
DOI 10.1046/j.1365-2265.2000.01014.x
Volume 52
Issue 6
Start page 765
End page 773
Total pages 9
Place of publication Oxford
Publisher Blackwell Publishing
Language eng
Subject 1103 Clinical Sciences
Formatted abstract Aims
To compare the efficacy of remnant ablation following a single low dose (specific activity of 131I administered, 1074–1110 MBq) vs. a single high dose (mostly 2775–3700 MBq) of 131I in patients with differentiated thyroid cancer and to determine whether or not the extent of surgery influences outcome.

Methods
Nineteen studies have reported the results of low dose 131I ablation. Of these, 11 met our criteria for a comparative analysis. Two additional cohorts of ours were added and these were analysed in two groups based on the extent of surgery (near-total [NT; Woodhouse1] vs. sub-total [ST; Woodhouse2]). There were 518 low dose and 449 high dose patients in all.

Results
The average failure of a single low dose was 46 ± 28% (SD). Meta-analysis revealed a statistically significant advantage for a single high over a single low dose and a pooled reduction in relative risk of failure of the high dose of about 27% (P < 0.01). From this we estimate that for every seven patients treated one more would be ablated given a high rather than a low dose (assuming a low dose failure risk of 50%). Also, a significantly greater proportion of patients are ablated after a single high or low dose, if they underwent near-total as opposed to sub-total thyroidectomy (summary relative risk (RR) 1.4; P < 0.05).

Conclusion
High dose 131I is more efficient than low dose for remnant ablation particularly after less than total thyroidectomy. Results suggest that patients with differentiated thyroid cancer should routinely have a total thyroidectomy followed by high dose 131I (2775–3700MBq) for ablation of the remnant.
Keyword RADIOACTIVE IODINE
RADIOIODINE ABLATION
FOLLOW-UP
CARCINOMA
THERAPY
PAPILLARY
METAANALYSIS
EFFICACY
TRIALS
TISSUE
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Population Health Publications
 
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