Appropriate dosing of adjuvant radioactive iodine for differentiated thyroid cancer
- 1 January 2014
- journal article
- review article
- Published by Ovid Technologies (Wolters Kluwer Health) in Current Opinion in Oncology
- Vol. 26 (1), 31-35
- https://doi.org/10.1097/cco.0000000000000039
Abstract
The incidence of well differentiated thyroid cancer (WDTC) is increasing in the US population and is now a major public health concern. Although surgery is the mainstay of treatment, radioactive iodine (RAI) is routinely used for adjuvant therapy, remnant ablation, and for the treatment of metastatic disease. Despite excellent prognosis and stable mortality rates, the use of RAI is increasing in many low and intermediate risk WDTC patients without clear indication that it changes the outcome. As a result, the current treatment paradigm has shifted towards a risk-stratified approach. Although there is widespread acceptance that RAI improves overall and recurrence-free survival in patients with metastatic disease, controversy remains regarding radioactive remnant ablation use in low and intermediate risk patients. Additional studies have shown that reduced doses of RAI can provide similar rates of remnant ablation and adjuvant therapy in low and intermediate risk patients without adversely affecting the recurrence rates and mortality. Recent studies suggest potential new paradigms in radioactive remnant ablation dosing and indications for use. Risk stratification is important in determining the proper use and dosing of RAI.Keywords
This publication has 24 references indexed in Scilit:
- Annual Report to the Nation on the status of cancer, 1975‐2008, featuring cancers associated with excess weight and lack of sufficient physical activityCancer, 2012
- Clinical Features and Prognostic Factors for Survival in Patients with Poorly Differentiated Thyroid Carcinoma and Comparison to the Patients with the Aggressive Variants of Papillary Thyroid CarcinomaEndocrine Journal, 2007
- Local and regional control in patients with papillary thyroid carcinoma: specific indications of external radiotherapy and radioactive iodine according to T and N categories in AJCC 6th editionEndocrine-Related Cancer, 2006
- Outcomes of Patients with Differentiated Thyroid Carcinoma Following Initial TherapyThyroid®, 2006
- Long-Term Outcome of 444 Patients with Distant Metastases from Papillary and Follicular Thyroid Carcinoma: Benefits and Limits of Radioiodine TherapyJournal of Clinical Endocrinology & Metabolism, 2006
- A National Cancer Data Base report on 53,856 cases of thyroid carcinoma treated in the U.S., 1985-1995Cancer, 1998
- Long-term impact of initial and surgical therapy on papillary and follicular thyroid cancerThe American Journal of Medicine, 1994
- Long-term impact of initial surgical and medical therapy on papillary and follicular thyroid cancerThe American Journal of Medicine, 1994
- The results of various modalities of treatment of well differentiated thyroid carcinomas: a retrospective review of 1599 patientsJournal of Clinical Endocrinology & Metabolism, 1992
- Treatment of Thyroid CancerJAMA, 1970