Treatment of iodine-negative thyroglobulin-positive thyroid cancer: differences in outcome in patients with macrometastases and patients with micrometastases

European Journal of Nuclear Medicine and Molecular Imaging
Levent KabasakalIlhami Uslu

Abstract

During the follow-up of patients with well-differentiated thyroid carcinoma, some patients have elevated serum thyroglobulin (Tg) levels without any evidence of radioiodine accumulation on diagnostic whole-body scan (d-WBS). The treatment strategy in these patients is considered a clinical dilemma, with some groups recommending blind use of high-dose radioiodine therapy. The aim of this study was to evaluate whether or not high doses of radioiodine have beneficial effects in these patients. Twenty-seven patients were included in the study. All patients had negative d-WBS and elevated levels of Tg. All received high doses of radioiodine. The mean follow-up period was 6.3+/-5.8 years. There were 11 patients with macrometastases and 16 with micrometastases. Post-treatment WBS revealed radioiodine accumulation in 19 of 24 (79%) patients. Serum Tg levels were decreased in 8 of 16 (50%) patients. Among patients with micrometastases, five out of seven (71%) demonstrated a decrease in serum Tg levels. Among patients with macrometastases, three out of nine (33%) demonstrated a decrease in Tg values and three (33%) have died due to metastatic thyroid cancer. Radioiodine treatment may have a beneficial therapeutic effect in patients who h...Continue Reading

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Citations

Oct 18, 2006·Thyroid : Official Journal of the American Thyroid Association·F CourbonPh Caron
Jan 20, 2006·Thyroid : Official Journal of the American Thyroid Association·David S CooperUNKNOWN American Thyroid Association Guidelines Taskforce
Oct 29, 2009·Thyroid : Official Journal of the American Thyroid Association·UNKNOWN American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid CancerR Michael Tuttle
Jan 31, 2007·Thyroid : Official Journal of the American Thyroid Association·David C Howlett
Dec 2, 2008·Best Practice & Research. Clinical Endocrinology & Metabolism·Christoph ReinersMarkus Luster
Sep 23, 2008·Expert Opinion on Pharmacotherapy·Jennifer A Sipos, Ernest L Mazzaferri
Jun 22, 2010·Clinical Oncology : a Journal of the Royal College of Radiologists·M Chao
Aug 15, 2018·Thyroid : Official Journal of the American Thyroid Association·Douglas Van Nostrand
Jan 31, 2006·Arquivos brasileiros de endocrinologia e metabologia·Lenara GolbertJorge Luiz Gross

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