Long-Term Outcome of 444 Patients with Distant Metastases from Papillary and Follicular Thyroid Carcinoma: Benefits and Limits of Radioiodine Therapy

Autor: F. de Vathaire, Martin Schlumberger, Eric Baudin, D. Hartl, Marcel Ricard, Nadia Haddy, Sophie Leboulleux, Bernard Caillou, Cosimo Durante, Jean Lumbroso, Jean-Paul Travagli
Přispěvatelé: Médecine nucléaire, Département d'imagerie médicale [Gustave Roussy], Institut Gustave Roussy (IGR)-Institut Gustave Roussy (IGR), Epidémiologie des cancers : Radiocarcinogénèse et effets iatrogènes des traitements, Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), LPP - Laboratoire de Phonétique et Phonologie - UMR 7018 (LPP), Université Sorbonne Nouvelle - Paris 3-Centre National de la Recherche Scientifique (CNRS), Département d'O.R.L. et Chirurgie Cervico-Faciale, Institut Gustave Roussy (IGR)
Rok vydání: 2006
Předmět:
Male
Lung Neoplasms
MESH: Carcinoma
Papillary
Endocrinology
Diabetes and Metabolism
Clinical Biochemistry
MESH: Adenocarcinoma
Follicular
Biochemistry
Metastasis
Iodine Radioisotopes
0302 clinical medicine
Endocrinology
Thyroid Hormone Treatment
MESH: Child
Adenocarcinoma
Follicular
Neoplasm Metastasis
Child
Thyroid cancer
MESH: Treatment Outcome
MESH: Aged
MESH: Middle Aged
Bone metastasis
MESH: Iodine Radioisotopes
Middle Aged
Prognosis
MESH: Bone Neoplasms
3. Good health
Survival Rate
Treatment Outcome
MESH: Thyroid Neoplasms
Child
Preschool
030220 oncology & carcinogenesis
Adenocarcinoma
Female
Adult
medicine.medical_specialty
Adolescent
MESH: Survival Rate
Bone Neoplasms
030209 endocrinology & metabolism
MESH: Prognosis
Thyroid carcinoma
03 medical and health sciences
Internal medicine
medicine
Carcinoma
Humans
Thyroid Neoplasms
Survival rate
Aged
MESH: Adolescent
MESH: Humans
business.industry
MESH: Child
Preschool
Biochemistry (medical)
MESH: Adult
medicine.disease
MESH: Neoplasm Metastasis
Carcinoma
Papillary
MESH: Male
MESH: Lung Neoplasms
[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie
business
MESH: Female
Zdroj: Journal of Clinical Endocrinology and Metabolism
Journal of Clinical Endocrinology and Metabolism, Endocrine Society, 2006, 91 (8), pp.2892-9. ⟨10.1210/jc.2005-2838⟩
ISSN: 1945-7197
0021-972X
DOI: 10.1210/jc.2005-2838
Popis: AIM: The goal of this study was to estimate the cumulative activity of (131)I to be administered to patients with distant metastases from thyroid carcinoma. METHODS: A total of 444 patients were treated from 1953-1994 for distant metastases from papillary and follicular thyroid carcinoma: 223 had lung metastases only, 115 had bone metastases only, 82 had both lung and bone metastases, and 24 had metastases at other sites. Treatment consisted of the administration of 3.7 GBq (100 mCi) (131)I after withdrawal of thyroid hormone treatment, every 3-9 months during the first 2 yr and then once a year until the disappearance of any metastatic uptake. Thyroxine treatment was given at suppressive doses between (131)I treatment courses. RESULTS: Negative imaging studies (negative total body (131)I scans and conventional radiographs) were attained in 43% of the 295 patients with (131)I uptake; more frequently in those who were younger, had well-differentiated tumors, and had a limited extent of disease. Most negative studies (96%) were obtained after the administration of 3.7-22 GBq (100-600 mCi). Almost half of negative studies were obtained more than 5 yr after the initiation of the treatment of metastases. Among patients who achieved a negative study, only 7% experienced a subsequent tumor recurrence. Overall survival at 10 yr after initiation of (131)I treatment was 92% in patients who achieved a negative study and 19% in those who did not. CONCLUSION: (131)I treatment is highly effective in younger patients with (131)I uptake and with small metastases. They should be treated until the disappearance of any uptake or until a cumulative activity of 22 GBq has been administered. In the other patients, other treatment modalities should be used when tumor progression has been documented.
Databáze: OpenAIRE
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