Maximal safe dose of I-131 after failure of standard fixed dose therapy in patients with differentiated thyroid carcinoma.

Abstract:

OBJECTIVE:The maximal safe dose (MSD) on the basis of bone marrow irradiation levels allows the delivery of a large amount of I-131 to thyroid cancer tissue. The efficacy of MSD therapy in differentiated metastatic thyroid cancers that persisted after conventional fixed dose therapy is investigated. METHODS:Forty-seven differentiated thyroid carcinoma patients with non-responsive residual disease despite repetitive fixed dose I-131 therapy were enrolled in this study. Their postoperative pathologies were 43 papillary carcinomas and 4 follicular carcinomas. The MSD was calculated with the Memorial Sloan-Kettering Cancer Center protocol using serial blood samples. The MSDs were administered at intervals of 6 months. Treatment responses were evaluated using I-131 whole-body scans and serum thyroglobulin measurements. RESULTS:The mean calculated MSD was 12.5 +/- 2.1 GBq (339.6 +/- 57.5 mCi). Of the 46 patients, 7 (14.9%) showed complete remission, 15 (31.9%) partial remission, 19 (40.4%) stable disease, and 6 (12.8%) disease progression. Of the patients who showed complete or partial remission, 15 (65%) showed response after the first MSD session and 6 (26%) showed response after the second session. Twenty-nine patients (62%) experienced transient cytopenia after therapy, but three did not recover to the baseline level. CONCLUSIONS:The maximal safe dose provides an effective means of treatment in patients who failed to respond adequately to conventional fixed dose therapy. I-131 MSD therapy can be considered in patients who fail fixed dose therapy.

journal_name

Ann Nucl Med

authors

Lee JJ,Chung JK,Kim SE,Kang WJ,Park DJ,Lee DS,Cho BY,Lee MC

doi

10.1007/s12149-007-0179-8

subject

Has Abstract

pub_date

2008-11-01 00:00:00

pages

727-34

issue

9

eissn

0914-7187

issn

1864-6433

journal_volume

22

pub_type

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