Strategies of Radioiodine Ablation in Patients with Low-Risk Thyroid Cancer

• Published in: The New England journal of medicine Vol. 366; no. 18; pp. 1663 - 1673
• Main Authors: Schlumberger, Martin, Catargi, Bogdan, Borget, Isabelle, Deandreis, Désirée, Zerdoud, Slimane, Bridji, Boumédiène, Bardet, Stéphane, Leenhardt, Laurence, Bastie, Delphine, Schvartz, Claire, Vera, Pierre, Morel, Olivier, Benisvy, Danielle, Bournaud, Claire, Bonichon, Françoise, Dejax, Catherine, Toubert, Marie-Elisabeth, Leboulleux, Sophie, Ricard, Marcel, Benhamou, Ellen
• Format: Journal Article
• Language: English
• Published: Waltham, MA Massachusetts Medical Society 03.05.2012
• Subjects: Ablation; Ablation Techniques; Adenocarcinoma, Follicular - drug therapy; Adenocarcinoma, Follicular - radiotherapy; Adenocarcinoma, Follicular - surgery; Adult; Biological and medical sciences; Cancer; Carcinoma, Papillary - drug therapy; Carcinoma, Papillary - radiotherapy; Carcinoma, Papillary - surgery; Combined Modality Therapy; Contamination; Endocrinopathies; Event-related potentials; Female; Follow-Up Studies; General aspects; Humans; Hypothyroidism - etiology; Iodine; Iodine Radioisotopes - adverse effects; Iodine Radioisotopes - therapeutic use; Male; Malignant tumors; Medical sciences; Metastases; Middle Aged; Neck; Neck - diagnostic imaging; Non tumoral diseases. Target tissue resistance. Benign neoplasms; Quality of Life; Thyroglobulin; Thyroid cancer; Thyroid carcinoma; Thyroid gland; Thyroid Hormones - blood; Thyroid Hormones - therapeutic use; Thyroid Neoplasms - drug therapy; Thyroid Neoplasms - radiotherapy; Thyroid Neoplasms - surgery; Thyroid-stimulating hormone; Thyroid. Thyroid axis (diseases); Thyroidectomy; Thyrotropin - adverse effects; Thyrotropin - therapeutic use; Treatment Outcome; Ultrasonography; Ultrasound; Endocrinopathy; Human; Medicine; Thyroid cancer; Thyroid diseases; Patient; Strategy; Malignant tumor; Ablation; Low risk; Cancer
• ISSN: 0028-4793; 1533-4406; 1533-4406
• DOI: 10.1056/NEJMoa1108586

This trial compared two thyrotropin-stimulation methods and two 131I doses for postoperative ablation in patients with low-risk thyroid cancer. Rates of ablation were similar in all treatment groups. Doses lower than those currently recommended may be adequate for this condition. Radioiodine ( 131 i) is administered to patients with thyroid cancer after total thyroidectomy for three reasons 1 – 3 : first, to eradicate normal-thyroid remnants (ablation) in order to achieve an undetectable serum thyroglobulin level; second, to irradiate any neoplastic focus in order to decrease the risk of recurrence; and third, to perform 131 I total-body scanning for persistent carcinoma. Successful ablation is defined by the combination of undetectable serum thyroglobulin levels after thyrotropin stimulation and normal results on neck ultrasonography 6 to 12 months after 131 I administration. 2 , 3 When these criteria are met, approximately 1% of patients have a recurrence. 4 – 6 In . . .