the radioactive iodine therapy in Graves’ disease patients . BMC Endocrine Disorders 2020 20 76. ( https://doi.org/10.1186/s12902-020-00557-w ) 11 Boelaert K Syed AA Manji N Sheppard MC Holder RL Gough SC Franklyn JA . Prediction of
Lian Duan, Han-Yu Zhang, Min Lv, Han Zhang, Yao Chen, Ting Wang, Yan Li, Yan Wu, Junfeng Li, and Kefeng Li
Keiko Ohkuwa, Kiminori Sugino, Mitsuji Nagahama, Wataru Kitagawa, Kenichi Matsuzu, Akifumi Suzuki, Chisato Tomoda, Kiyomi Hames, Junko Akaishi, Chie Masaki, and Koichi Ito
Radioactive iodine (RAI) therapy is effective for differentiated thyroid cancer (DTC) patients with lung metastasis. However, some patients have a poor prognosis despite the RAI accumulation. The utility of inflammatory biomarkers, including neutrophil-to-lymphocyte ratio (NLR), has been reported as a prognostic factor for many carcinomas. This study aimed to investigate the risk factors related to DTC patient survival with RAI-avid lung metastasis and to attempt risk stratification.
Design and methods
This retrospective study included 123 patients with RAI-accumulating lung metastatic DTC. The cause-specific survival (CSS) rate from the time of detection of lung metastasis was tested using the Kaplan–Meier log-rank test, and the multivariate analysis was calculated using the Cox proportional hazards model. NLR was retrospectively calculated using the blood sample collected before initial RAI treatment. The NLR cutoff value was 2.6 on the ROC curve.
Age ≥ 55 years at the time of operative treatment, follicular carcinoma, lung metastasis tumor ≥ 10 mm in diameter, age ≥ 55 years at the time of detection of lung metastasis, age ≥ 55 years at the time of RAI treatment, and NLR ≥ 2.6 at the initial RAI treatment were predictive of decreased CSS. Multivariate analysis identified that the independent prognostic factors were lung metastatic tumor ≥ 10 mm in diameter and NLR ≥ 2.6. Patients in the high-risk group with both factors had significantly lower CSS rates than those in the low- and intermediate-risk groups with one or none of these factors.
The high-risk group patients had significantly poorer survival, and these patients could be considered as future candidates for tyrosine kinase inhibitor therapy.
Eugenie S Lim, Shanty G Shah, Mona Waterhouse, Scott Akker, William Drake, Nick Plowman, Daniel M Berney, Polly Richards, Ashok Adams, Ewa Nowosinska, Carmel Brennan, and Maralyn Druce
Differentiated thyroid cancer (DTC) is usually treated by thyroidectomy followed by radioiodine ablation and generally has a good prognosis. It may now be possible to limit the amount of treatment without impacting on efficacy. It is not known whether coexistent thyroiditis impacts on radioiodine uptake or on its potential efficacy, but this could provide a rationale for modification to current therapeutic protocols.
This was a retrospective cohort study of radioiodine uptake on imaging after radioiodine ablation for DTC in patients with and without concurrent thyroiditis. All patients with histologically confirmed DTC treated with radioiodine ablation after thyroidectomy in a single centre from 2012 to 2015 were included. The primary outcome assessed was the presence of low or no iodine uptake on post-ablation scan, as reported by a nuclear medicine physician blinded to the presence or absence of thyroiditis.
One hundred thirty patients with available histopathology results were included. Thyroiditis was identified in 42 post-operative specimens and 15 of these patients had low or no iodine uptake on post-ablation scan, compared to only 2 of 88 patients without thyroiditis (P < 0.0001) with further data analysis dividing the groups by ablation activity received (1100 MBq or 3000 MBq).
Concurrent thyroiditis may impair the uptake of radioactive iodine in management of DTC. Given that patients with DTC and thyroiditis already have a good prognosis, adopting a more selective approach to this step in therapy may be indicated. Large, longitudinal studies would be required to determine if omitting radioactive iodine therapy from those patients with concurrent thyroiditis has a measurable impact on mortality from thyroid cancer.
Muthiah Subramanian, Manu Kurian Baby, and Krishna G Seshadri
propylthiouracil before radioactive iodine therapy is associated with a higher treatment failure rate than therapy with radioactive iodine alone in Graves' disease . Thyroid 1995 5 243 – 247 . ( doi:10.1089/thy.1995.5.243 ). 11 Walter MA Christ-Crain M
Agnieszka Adamska, Paulina Tomczuk-Bobik, Anna Beata Popławska-Kita, Katarzyna Siewko, Angelika Buczyńska, Piotr Szumowski, Łukasz Żukowski, Janusz Myśliwiec, Monika Zbucka-Krętowska, Marcin Adamski, and Adam Jacek Krętowski
force on thyroid nodules and differentiated thyroid cancer . Thyroid 2016 26 1 – 133 . ( https://doi.org/10.1089/thy.2015.0020 ) 3 Evranos B Faki S Polat SB Bestepe N Ersoy R Cakir B . Effects of radioactive iodine therapy on ovarian
Norra Kwong, Ellen Marqusee, Michael S Gordon, P Reed Larsen, Jeffrey R Garber, Matthew I Kim, and Erik K Alexander
radioactive iodine therapy at the age of 33, the patient has received no further treatment beyond thyroid hormone-suppressive therapy. Since age 53, the patient has undergone annual CT scans of the lungs revealing persistent, but stable, pulmonary metastases
Kunal Thakkar, Swati Ramteke-Jadhav, Rajeev Kasaliwal, Saba Samad Memon, Virendra Patil, Puja Thadani, Nilesh Lomte, Shilpa Sankhe, Atul Goel, Sridhar Epari, Naina Goel, Anurag Lila, Nalini S Shah, and Tushar Bandgar
had clinical evidence of DI. Thyroid surgery, radiotherapy to pituitary metastases, and radioactive iodine therapy for pulmonary metastases were planned. However, she succumbed to rapidly progressive intracranial metastasis within 3 months. Accounting
Danuta Gąsior-Perczak, Iwona Pałyga, Monika Szymonek, Artur Kowalik, Agnieszka Walczyk, Janusz Kopczyński, Katarzyna Lizis-Kolus, Anna Słuszniak, Janusz Słuszniak, Tomasz Łopatyński, Ryszard Mężyk, Stanisław Góźdź, and Aldona Kowalska
the TT group than in the L group (63.4% vs 25.5%) on histopathological examination. Table 1 Characteristics of DTC patients treated with total thyroidectomy or lobectomy without adjuvant radioactive iodine therapy. Characteristics
Chun-feng Lu, Wang-shu Liu, Xiao-qin Ge, Feng Xu, Jian-bin Su, Xue-qin Wang, and Yan Wang
, which may create difficulties in treating this disease ( 3 ). Treatments for GD include oral antithyroid drugs, radioactive iodine therapy (RAI), and surgery, but each treatment regimen has the possibility of side effects ( 4 ). From this statement
Sara Ahmadi, Alexandra Coleman, Nathalie Silva de Morais, Iñigo Landa, Theodora Pappa, Alex Kang, Matthew I Kim, Ellen Marqusee, and Erik K Alexander
thyroid cancer patients with low risk of distant metastases receiving radioactive iodine therapy. SPECT-CT imaging led to some additional findings that were beneficial to thyroid cancer care while also detecting a significant proportion of false and