Campennì Alfredo, Ruggeri Rosaria Maddalena, Garo Maria Luisa, Siracusa Massimiliano, Restuccia Giovanna, Rappazzo Andrea, Rosarno Helena, Nicocia Antonio, Cardile Davide, Ovčariček Petra Petranović, Baldari Sergio, Giovanella Luca
Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, Unit of Nuclear Medicine, University of Messina, 98125 Messina, Italy.
Department of Human Pathology DETEV, Unit of Endocrinology, University of Messina, 98122 Messina, Italy.
Cancers (Basel). 2023 Apr 22;15(9):2416. doi: 10.3390/cancers15092416.
To compare the efficacy of low and moderate I activities in low-risk differentiated thyroid carcinoma (DTC) patients requiring postoperative thyroid remnant ablation in a real-world clinical setting.
We retrospectively reviewed the records of 299 low-risk DTC patients (pT1-T2, Nx(0) Mx) who had undergone (near)-total thyroidectomy followed by I therapy, using either low (1.1 GBq) or moderate (2.2 GBq) radioiodine activities. The response to initial treatments was evaluated after 8-12 months, and patient responses were classified according to the 2015 American Thyroid Association guidelines.
An excellent response was observed in 274/299 (91.6%) patients, specifically, in 119/139 (85.6%) and 155/160 (96.9%) patients treated with low and moderate I activities, respectively ( = 0.029). A biochemically indeterminate or incomplete response was observed in seventeen (22.2%) patients treated with low I activities and three (1.8%) patients treated with moderate I activities ( = 0.001). Finally, five patients showed an incomplete structural response, among which three and two received low and moderate I activities, respectively ( = 0.654).
When I ablation is indicated, we encourage the use of moderate instead of low activities, in order to reach an excellent response in a significantly larger proportion of patients, including patients with the unexpected persistence of the disease.
在真实临床环境中比较低剂量和中等剂量碘-131 活度对需要术后甲状腺残余组织消融的低危分化型甲状腺癌（DTC）患者的疗效。
我们回顾性分析了 299 例低危 DTC 患者（pT1-T2，Nx(0) Mx）的记录，这些患者接受了（近）全甲状腺切除术后进行碘-131 治疗，使用低剂量（1.1 GBq）或中等剂量（2.2 GBq）的放射性碘活度。在 8 - 12 个月后评估初始治疗的反应，并根据 2015 年美国甲状腺协会指南对患者反应进行分类。
299 例患者中有 274 例（91.6%）获得了良好反应，具体而言，低剂量和中等剂量碘-131 活度治疗的患者分别为 119/139 例（85.6%）和 155/160 例（96.9%）（P = 0.029）。低剂量碘-131 活度治疗的 17 例（22.2%）患者和中等剂量碘-131 活度治疗的 3 例（1.8%）患者出现生化不确定或不完全反应（P = 0.001）。最后，5 例患者出现不完全结构反应，其中 3 例和 2 例分别接受了低剂量和中等剂量碘-131 活度治疗（P = 0.654）。
当需要进行碘-131 消融时，我们鼓励使用中等剂量而非低剂量活度，以便在更大比例的患者中，包括疾病意外持续存在的患者中获得良好反应。
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