Second radioiodine treatment in patients with differentiated thyroid carcinoma: Causes and effects.

Autor: Sicilia Pozo MLN; Servicio de Medicina Nuclear, Hospital Universitario de Ciudad Real, C/ Obispo Rafael Torija, S/N, 13005 Ciudad Real, Spain. Electronic address: abusici29@gmail.com., Pena Pardo FJ; Servicio de Medicina Nuclear, Hospital Universitario de Ciudad Real, C/ Obispo Rafael Torija, S/N, 13005 Ciudad Real, Spain., Amo Salas M; Departamento de Matemáticas, Universidad de Castilla La Mancha, Avda. Camilo José Cela, s/n, 13071 Ciudad Real, Spain., Cruz Montijano M; Servicio de Medicina Nuclear, Hospital Universitario de Ciudad Real, C/ Obispo Rafael Torija, S/N, 13005 Ciudad Real, Spain., Torres Hernández J; Servicio de Bioquímica Clínica, Complejo Hospitalario Universitario de Albacete, C/ Hermanos Falco, 37, 02008 Albacete, Spain., Padilla Bermejo A; Servicio de Medicina Nuclear, Hospital Universitario de Ciudad Real, C/ Obispo Rafael Torija, S/N, 13005 Ciudad Real, Spain., Montalbán Méndez C; Servicio de Endocrinología, Hospital General La Mancha Centro, Avda. de la Constitución, 3, 13600 Alcázar de San Juan, Ciudad Real, Spain., Zhao Montero M; Servicio de Endocrinología, Hospital General La Mancha Centro, Avda. de la Constitución, 3, 13600 Alcázar de San Juan, Ciudad Real, Spain., Soriano Castrejón Á; Servicio de Medicina Nuclear, Hospital Universitario de Ciudad Real, C/ Obispo Rafael Torija, S/N, 13005 Ciudad Real, Spain., García Vicente AM; Servicio de Medicina Nuclear, Hospital Universitario de Ciudad Real, C/ Obispo Rafael Torija, S/N, 13005 Ciudad Real, Spain.
Jazyk: angličtina
Zdroj: Endocrinologia, diabetes y nutricion [Endocrinol Diabetes Nutr (Engl Ed)] 2024 Jan; Vol. 71 (1), pp. 4-11.
DOI: 10.1016/j.endien.2024.02.001
Abstrakt: Introduction: Patients with incomplete response to initial therapy of thyroid cancer can be managed with ongoing observation or potentially additional therapies. Our aim was to assess the effect of a second radioactive iodine treatment (RAIT) and its relationship with causes and clinical variables.
Material and Methods: Patients undergoing a second RAIT for biochemical or structural incomplete response to initial therapy of DTC were retrospectively included (n=120). They were categorised based on the American Thyroid Association (ATA) classification of response to initial therapy. Patients were reclassified in the following 6-18 months after second RAIT based on imaging findings and measurements of thyroglobulin and antithyroglobulin antibody levels. The associations of a downgrading of response category and progression-free survival (PFS), and the related variables, were evaluated.
Results: Sixty-six patients (55%) had a downgrading on ATA response category after second RAIT. A significant interdependence of causes for second RAIT and outcomes was found (χ 2 =29.400, p=0.001), with patients with neck reoperation showing a higher rate of indeterminate or excellent responses. A significant association between ATA response to second RAIT and absence of structural progression was found (χ 2 =44.914, p<0.001), with less structural progression in patients with downgrading on ATA response (χ 2 =30.914, p<0.001). There was also significant interdependence to some clinical variables, such as AJCC stage (χ 2 =8.460, p=0.015), ATA risk classification (χ 2 =10.694, p=0.005) and initial N stage (χ 2 =8.485, p=0.004).
Conclusions: In selected cases, a second RAIT could lead to more robust responses with a potential improvement in prognosis in patients with incomplete response to initial DTC treatment.
(Copyright © 2023 SEEN and SED. Published by Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
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