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Low versus high radioiodine activity for ablation of the thyroid remnant after thyroidectomy in Han Chinese with low-risk differentiated thyroid cancer

Authors Lv RB, Wang QG, Liu C, Liu F, Zhao Q, Han JG, Ren DL, Liu B, Li CL

Received 19 February 2017

Accepted for publication 5 July 2017

Published 14 August 2017 Volume 2017:10 Pages 4051—4057

DOI https://doi.org/10.2147/OTT.S135145

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Akshita Wason

Peer reviewer comments 5

Editor who approved publication: Dr XuYu Yang

Rong-Bin Lv,1,2 Qing-Gang Wang,2 Chao Liu,2 Fang Liu,2 Qing Zhao,3 Jian-Guo Han,2 Dao-Ling Ren,2 Bin Liu,2 Cheng-Li Li1

1Department of Interventional MRI, Shandong Medical Imaging Research Institute, Shandong University, Shandong, People’s Republic of China; 2Department of Nuclear Medicine, Taian City Central Hospital, Shandong, People’s Republic of China; 3Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China

Aim:
The aim of this study was to compare the efficacy and adverse effects of radioiodine (131I) therapy between two groups of patients with low-risk differentiated thyroid cancer (DTC) who received 30 mCi or 100 mCi radioiodine for ablation of the thyroid remnant after total thyroidectomy.
Methods: The study cohort was 173 patients, 85 of whom were given 30 mCi of radioiodine and the others were given 100 mCi of radioiodine. Follow-up involved neck ultrasonography, measurement of serum levels of thyroglobulin and whole-body scans to evaluate the response of radioiodine treatment. All patients were assessed for adverse effects.
Results: Of the 173 patients, 170 (98.3%) patients finally achieved successful ablation. The prevalence of successful ablation was 77.6% in the low-dose group versus 71.5% in the high-dose group after the first dose administration (P=0.36), 79% in the low-dose group versus 88% in the high-dose group after the second dose administration (P=0.416), and 97.6% in the low-dose group versus 98.9% in the high-dose group after the final ablation (P=0.54). We found no significant differences between the two groups. No patient had an adverse effect with a severity grade >2 and the prevalence of adverse effects in the high-dose group was higher than that in the low-dose group, especially for nausea, neck pain, and sore throat.
Conclusion: These data suggest that a low dose of radioiodine is as effective as a high dose of radioiodine for ablation of the thyroid remnant after total thyroidectomy for low-risk DTC. Moreover, low-dose radioiodine therapy is associated with a lower prevalence of adverse events.

Keywords:
differentiated thyroid cancer, radioiodine, radiotherapy, thyroglobulin

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