Rachinsky I, Rajaraman M, Leslie W D, Zahedi A, Jefford C, McGibbon A, Young J E M, Pathak K A, Badreddine M, De Brabandere S, Fong H, Van Uum S
Department of Nuclear Medicine, Western University, London, ON, Canada.
Department of Radiation Oncology, Dalhousie University, Halifax, NS, Canada.
J Thyroid Res. 2016;2016:2867916. doi: 10.1155/2016/2867916. Epub 2016 Nov 29.
. Use of radioactive iodine (RAI) ablation has been reported to vary significantly between studies. We explored variation in RAI ablation care patterns between seven thyroid cancer treatment centers in Canada. . The Canadian Collaborative Network for Cancer of the Thyroid (CANNECT) is a collaborative registry to describe and analyze patterns of care for thyroid cancer. We analyzed data from seven participating centers on RAI ablation in patients diagnosed with well-differentiated (papillary and follicular) thyroid cancer between 2000 and 2010. We compared RAI ablation protocols including indications (based on TNM staging), preparation protocols, and administered dose. We excluded patients with known distant metastases at time of RAI ablation. . We included 3072 patients. There were no significant differences in TNM stage over time. RAI use increased in earlier years and then declined. The fraction of patients receiving RAI varied significantly between centers, ranging between 20-85% for T1, 44-100% for T2, 58-100% for T3, and 59-100% for T4. There were significant differences in the RAI doses between centers. Finally, there was major variation in the use of thyroid hormone withdrawal or rhTSH for preparation of RAI ablation. . Our study identified significant variation in use of RAI for ablation in patients with well-differentiated thyroid cancer both between Canadian centers and over time.
据报道,不同研究中放射性碘(RAI)消融的使用情况差异显著。我们探讨了加拿大七个甲状腺癌治疗中心之间RAI消融治疗模式的差异。加拿大甲状腺癌协作网络(CANNECT)是一个用于描述和分析甲状腺癌治疗模式的协作登记处。我们分析了七个参与中心在2000年至2010年间对诊断为高分化(乳头状和滤泡状)甲状腺癌患者进行RAI消融的数据。我们比较了RAI消融方案,包括适应症(基于TNM分期)、准备方案和给药剂量。我们排除了RAI消融时已知有远处转移的患者。我们纳入了3072名患者。TNM分期随时间没有显著差异。RAI的使用在早期有所增加,然后下降。各中心接受RAI治疗的患者比例差异显著,T1期为20 - 85%,T2期为44 - 100%,T3期为58 - 100%,T4期为59 - 100%。各中心之间的RAI剂量存在显著差异。最后,在用于RAI消融准备的甲状腺激素撤减或重组人促甲状腺激素(rhTSH)的使用方面存在很大差异。我们的研究发现,加拿大各中心之间以及随时间推移,高分化甲状腺癌患者使用RAI进行消融的情况存在显著差异。