Usefulness of second 131I treatment in biochemical persistent differentiated thyroid cancer patients
Background: Second 131I treatment is commonly performed in clinical practice in patients with differentiated thyroid cancer and biochemical incomplete or indeterminate response (BiR/InR) after initial treatment. Objective: The objective of the is study is to evaluate the clinical impact of the sec...
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| Format: | Article |
| Language: | English |
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Bioscientifica
2023-10-01
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| Series: | European Thyroid Journal |
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| Online Access: | https://etj.bioscientifica.com/view/journals/etj/12/6/ETJ-23-0052.xml |
| _version_ | 1827786257168596992 |
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| author | Carla Gambale Alessandro Prete Lea Contartese Liborio Torregrossa Francesca Bianchi Eleonora Molinaro Gabriele Materazzi Rossella Elisei Antonio Matrone |
| author_facet | Carla Gambale Alessandro Prete Lea Contartese Liborio Torregrossa Francesca Bianchi Eleonora Molinaro Gabriele Materazzi Rossella Elisei Antonio Matrone |
| author_sort | Carla Gambale |
| collection | DOAJ |
| description | Background: Second 131I treatment is commonly performed in clinical practice in patients with differentiated thyroid cancer and biochemical incomplete or indeterminate response (BiR/InR) after initial treatment.
Objective: The objective of the is study is to evaluate the clinical impact of the second 131I treatment in BiR/InR patients and analyze the predictive factors for structural incomplete response (SiR).
Patients and methods: One hundred fifty-three BiR/InR patients after initial treatment who received a second 131I treatment were included in the study. The clinical response in a short- and medium- long-term follow-up was evaluated.
Results: After the second 131I treatment (median 8 months), 11.8% patients showed excellent response (ER), 17% SiR, while BiR/InR persisted in 71.2%. Less than half (38.5%) of SiR patients had radioiodine-avid metastases. Patients who, following the second 131I treatment, experienced SiR had larger tumor size and more frequently aggressive histology and vascular invasion than those experienced BiR/InR and ER. Also, the median values of thyroglobulin on levothyroxine therapy (LT4-Tg), Tg peak after recombinant human TSH stimulation (rhTSH-Tg) and thyroglobulin antibodies (TgAb) were significantly higher in patients who developed SiR. At last evaluation (median: 9.9 years), BiR/ InR persisted in 57.5%, while 26.2% and 16.3% of the patients showed ER and SiR, respectively. About half of BiR/InR patients (71/153 (46.4%)) received further treatments after the second 131I treatment.
Conclusions: Radioiodine-avid metastatic disease detected by the second 131I is an infrequent finding in patients with BiR/InR after initial treatment. However, specific pathologic and biochemical features allow to better identify those cases with higher probability of developing SiR, thus improving the clinical effectiveness of performing a second 131I treatment. |
| first_indexed | 2024-03-11T16:30:53Z |
| format | Article |
| id | doaj.art-16dc935259754009ba1e17efc0aa37e8 |
| institution | Directory Open Access Journal |
| issn | 2235-0802 |
| language | English |
| last_indexed | 2024-03-11T16:30:53Z |
| publishDate | 2023-10-01 |
| publisher | Bioscientifica |
| record_format | Article |
| series | European Thyroid Journal |
| spelling | doaj.art-16dc935259754009ba1e17efc0aa37e82023-10-24T07:19:59ZengBioscientificaEuropean Thyroid Journal2235-08022023-10-01126112https://doi.org/10.1530/ETJ-23-0052Usefulness of second 131I treatment in biochemical persistent differentiated thyroid cancer patientsCarla Gambale0Alessandro Prete1Lea Contartese2Liborio Torregrossa3Francesca Bianchi4Eleonora Molinaro5Gabriele Materazzi6Rossella Elisei7Antonio Matrone8Department of Clinical and Experimental Medicine, Unit of Endocrinology, University Hospital of Pisa, Pisa, ItalyDepartment of Clinical and Experimental Medicine, Unit of Endocrinology, University Hospital of Pisa, Pisa, ItalyDepartment of Clinical and Experimental Medicine, Unit of Endocrinology, University Hospital of Pisa, Pisa, ItalyDepartment of Surgical, Medical, Molecular Pathology and Critical Area, Anatomic Pathology Section, University Hospital of Pisa, Pisa, ItalyDepartment of Nuclear Medicine, University Hospital of Pisa, Pisa, ItalyDepartment of Clinical and Experimental Medicine, Unit of Endocrinology, University Hospital of Pisa, Pisa, ItalyDepartment of Surgical, Medical, Molecular Pathology and Critical Area, Unit of Endocrine Surgery, University Hospital of Pisa, Pisa, ItalyDepartment of Clinical and Experimental Medicine, Unit of Endocrinology, University Hospital of Pisa, Pisa, ItalyDepartment of Clinical and Experimental Medicine, Unit of Endocrinology, University Hospital of Pisa, Pisa, ItalyBackground: Second 131I treatment is commonly performed in clinical practice in patients with differentiated thyroid cancer and biochemical incomplete or indeterminate response (BiR/InR) after initial treatment. Objective: The objective of the is study is to evaluate the clinical impact of the second 131I treatment in BiR/InR patients and analyze the predictive factors for structural incomplete response (SiR). Patients and methods: One hundred fifty-three BiR/InR patients after initial treatment who received a second 131I treatment were included in the study. The clinical response in a short- and medium- long-term follow-up was evaluated. Results: After the second 131I treatment (median 8 months), 11.8% patients showed excellent response (ER), 17% SiR, while BiR/InR persisted in 71.2%. Less than half (38.5%) of SiR patients had radioiodine-avid metastases. Patients who, following the second 131I treatment, experienced SiR had larger tumor size and more frequently aggressive histology and vascular invasion than those experienced BiR/InR and ER. Also, the median values of thyroglobulin on levothyroxine therapy (LT4-Tg), Tg peak after recombinant human TSH stimulation (rhTSH-Tg) and thyroglobulin antibodies (TgAb) were significantly higher in patients who developed SiR. At last evaluation (median: 9.9 years), BiR/ InR persisted in 57.5%, while 26.2% and 16.3% of the patients showed ER and SiR, respectively. About half of BiR/InR patients (71/153 (46.4%)) received further treatments after the second 131I treatment. Conclusions: Radioiodine-avid metastatic disease detected by the second 131I is an infrequent finding in patients with BiR/InR after initial treatment. However, specific pathologic and biochemical features allow to better identify those cases with higher probability of developing SiR, thus improving the clinical effectiveness of performing a second 131I treatment.https://etj.bioscientifica.com/view/journals/etj/12/6/ETJ-23-0052.xmldifferentiated thyroid cancerbiochemical incomplete responseindeterminate responseradioiodinethyroglobulinthyroglobulin antibodies |
| spellingShingle | Carla Gambale Alessandro Prete Lea Contartese Liborio Torregrossa Francesca Bianchi Eleonora Molinaro Gabriele Materazzi Rossella Elisei Antonio Matrone Usefulness of second 131I treatment in biochemical persistent differentiated thyroid cancer patients European Thyroid Journal differentiated thyroid cancer biochemical incomplete response indeterminate response radioiodine thyroglobulin thyroglobulin antibodies |
| title | Usefulness of second 131I treatment in biochemical persistent differentiated thyroid cancer patients |
| title_full | Usefulness of second 131I treatment in biochemical persistent differentiated thyroid cancer patients |
| title_fullStr | Usefulness of second 131I treatment in biochemical persistent differentiated thyroid cancer patients |
| title_full_unstemmed | Usefulness of second 131I treatment in biochemical persistent differentiated thyroid cancer patients |
| title_short | Usefulness of second 131I treatment in biochemical persistent differentiated thyroid cancer patients |
| title_sort | usefulness of second 131i treatment in biochemical persistent differentiated thyroid cancer patients |
| topic | differentiated thyroid cancer biochemical incomplete response indeterminate response radioiodine thyroglobulin thyroglobulin antibodies |
| url | https://etj.bioscientifica.com/view/journals/etj/12/6/ETJ-23-0052.xml |
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