Download PDF
CC BY-NC-ND 4.0 · World J Nucl Med 2021; 20(01): 17-22
DOI: 10.4103/wjnm.WJNM_24_20
Original Article

Comparison of radioiodine ablation rates between low versus high dose, and according to the surgeon's expertise in the low-risk group of differentiated thyroid cancer

Ghazal Norouzi
Department of Nuclear Medicine, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran
,
Babak Shafiei
Department of Nuclear Medicine, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran
,
Farzad Hadaegh
1   Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran
,
Mohsen Qutbi
Department of Nuclear Medicine, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran
,
Isa Asli
Department of Nuclear Medicine, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran
,
Esmail Jafari
2   The Persian Gulf Nuclear Medicine Research Center, Bushehr University of Medical Sciences, Bushehr
,
Hamid Javadi
3   Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
,
Majid Assadi
2   The Persian Gulf Nuclear Medicine Research Center, Bushehr University of Medical Sciences, Bushehr
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Abstract

Radioiodine ablation following surgery is the accepted treatment for patients with differentiated thyroid cancer (DTC). Since that surgical volume and radioiodine dose can have impact on treatment outcome, we aimed to evaluate them on the treatment outcome of low-risk DTC patients. Low-risk DTC patients were classified into four groups, including (1) thyroidectomy was performed by thyroid surgeon and low-dose (1850 MBq [30 mCi]) radioiodine was administered (n = 17), (2) thyroidectomy was performed by thyroid surgeon and high-dose (3700 MBq [100 mCi]) radioiodine was administered (n = 10), (3) thyroidectomy was performed by general surgeon and low-dose radioiodine was administered (n = 22), and (4) thyroidectomy was performed by general surgeon and high-dose radioiodine was administered (n = 29). All patients were followed at least for 6 months and also for evaluation of treatment success, neck sonography, thyroid-stimulating hormone-off, thyroglobulin (Tg)-off, and anti-Tg-off tests were performed. Furthermore, two common radioiodine treatment-associated side effects, including dry mouth, and nausea/vomiting were assessed for all patients. Seventy-eight low-risk DTC patients (female: 70 [89.7%]; male: 8 [10.3%]) aged from 18 to 78 years old with mean of 41.96 ± 13.42 years were enrolled in this study. In total, the treatment was successful in 96.2% of patients. There was no significant difference in treatment success among groups (P > 0.05), while there was a significant association among administered activity and side effects. In low dose patients, only one patient complained from dry mouth; however, 11/39 patients who received high dose of iodine complained from dry mouth (P = 0.002). In addition, 9/39 high dose patients suffered from vomiting/nausea, while none of low-dose patients suffered from vomiting/nausea (P = 0.001). In low-risk DTC patients, surgical volume and amounts of radioiodine had no significant impact on treatment results; therefore, low dose radioiodine following thyroidectomy may be preferable to low-risk DTC patients to avoid side effects.

Keywords

Radioiodine ablation - surgical volume - thyroid cancer - thyroidectomy

Financial support and sponsorship

Nil.




Publication History

Received: 03 April 2020

Accepted: 04 April 2020

Article published online:
30 March 2022

© 2021. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Azizmohammadi Z, Tabei F, Shafiei B, Babaei AA, Jukandan SM, Naghshine R, et al. A study of the time of hospital discharge of differentiated thyroid cancer patients after receiving iodine-131 for thyroid remnant ablation treatment. Hell J Nucl Med 2013;16:103-6.
  • 2 Tabei F, Neshandar Asli I, Azizmohammadi Z, Javadi H, Assadi M. Assessment of radioiodine clearance in patients with differentiated thyroid cancer. Radiat Prot Dosimetry 2012;152:323-7.
  • 3 Jafari E, Alavi M, Zal F. The evaluation of protective and mitigating effects of vitamin C against side effects induced by radioiodine therapy. Radiat Environ Biophys 2018;57:233-40.
  • 4 Qu Y, Huang R, Li L. Low- and high-dose radioiodine therapy for low-/intermediate-risk differentiated thyroid cancer: A preliminary clinical trial. Ann Nucl Med 2017;31:71-83.
  • 5 Hauch A, Al-Qurayshi Z, Randolph G, Kandil E. Total thyroidectomy is associated with increased risk of complications for low- and high-volume surgeons. Ann Surg Oncol 2014;21:3844-52.
  • 6 Meltzer C, Klau M, Gurushanthaiah D, Tsai J, Meng D, Radler L, et al. Surgeon volume in thyroid surgery: Surgical efficiency, outcomes, and utilization. Laryngoscope 2016;126:2630-9.
  • 7 Gourin CG, Tufano RP, Forastiere AA, Koch WM, Pawlik TM, Bristow RE. Volume-based trends in thyroid surgery. Arch Otolaryngol Head Neck Surg 2010;136:1191-8.
  • 8 Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 2015 American thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American thyroid association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid 2016;26:1-33.
  • 9 Fallahi B, Beiki D, Takavar A, Fard-Esfahani A, Gilani KA, Saghari M, et al. Low versus high radioiodine dose in postoperative ablation of residual thyroid tissue in patients with differentiated thyroid carcinoma: A large randomized clinical trial. Nucl Med Commun 2012;33:275-82.
  • 10 Schlumberger M, Catargi B, Borget I, Deandreis D, Zerdoud S, Bridji B, et al. Strategies of radioiodine ablation in patients with low-risk thyroid cancer. N Engl J Med 2012;366:1663-73.
  • 11 Al-Qurayshi Z, Robins R, Hauch A, Randolph GW, Kandil E. Association of surgeon volume with outcomes and cost savings following thyroidectomy: A national forecast. JAMA Otolaryngol Head Neck Surg 2016;142:32-9.
  • 12 Mallick U, Harmer C, Yap B, Wadsley J, Clarke S, Moss L, et al. Ablation with low-dose radioiodine and thyrotropin alfa in thyroid cancer. N Engl J Med 2012;366:1674-85.
  • 13 Jimenez Londoño GA, Garcia Vicente AM, Sastre Marcos J, Pena Pardo FJ, Amo-Salas M, Moreno Caballero M, et al. Low-dose radioiodine ablation in patients with low-risk differentiated thyroid cancer. Eur Thyroid J 2018;7:218-24.