Thyroid Science
5(10):1-5, 2010
Low Dose I-131 Therapy in Differentiated
Thyroid Cancer: An Initial Experience
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Ajit S. Shinto, MBBS, DRM, DNB,
MNAMS, PGDHA; T.B Culas, MS;
M.V. Suresh, MS;
J. Mathew, MS; Ajay Kumar, MCh; M.L. Dathan, MS,FRCS;
Sree Kumar
Pillai, MCh; and C.D. Joseph, MD,DABR
Nuclear Medicine Department,
Amala Institute of Medical Sciences,
Amalanagar, Thrissur -555, Kerala, India
Correspondence: Dr. Ajit S Shinto, Nuclear Medicine Dept.,
Amala Institute of Medical Sciences, Amalanagar, Thrissur -555, Kerala,
India
Office Tel: 04872304163 Personal cell: 09747714265 Fax: 04872304163
ajitshinto@gmail.com, ajitshinto@yahoo.com
Abstract.
Objective: Since the 1970s, low dose radioactive iodine-131 (RAI
or I-131) has been widely reported in the treatment of patients with
differentiated thyroid cancer (DTC). However, the clinical outcomes,
dosage of I-131, and criteria for successful ablation differ in the
various studies. The aim of this study was to assess the clinical
outcome 18 months after RAI therapy in selected DTC patients, and to
identify factors associated with a good response.
Methods: In this experimental study, 105 subjects were
randomly selected from patients with DTC referred to the Nuclear
Medicine Department between December 2008 and April 2010 and who had
indications for RAI therapy. Patients were randomly divided into 3
groups to receive an empiric low-dose therapy of either 30, 40, or 50
mCi of I-131. For 18 months after treatment, at 6-month intervals,
patients were monitored closely clinically, with serum thyroglobulin
assays, and with I-131 whole-body scans.
Results: Among 105 patients who completed followup, 86 % were
successfully ablated with a single low dose of I-131. There was no
statistically-significant difference in ablation rates between the
subgroups that receive 30,40, or 50 mCi of I-131. The cumulative
ablation rate was 99% in patients after the second dose of low dose
therapy. Conclusion: If appropriate
selection criteria are used in DTC, successful remnant ablation can be
achieved with low doses of I-131 in the range of 30-to-50 mCi. No
significant differences were found in results achieved with 30, 40, or
50 mCi of I-131I. As the majority of the DTC patients fall within the
inclusion criteria of this study, they can be treated on an ambulatory
basis with associated low cost, convenience, and a low whole-body
radiation-absorbed dose of I-131.
Keywords • Hyperthyroidism • Graves’ disease • Radioiodine therapy • Outcome
• Hypothyroidism
Citation:
Shinto, A.S., T.B Culas, T.B., Suresh, M.V., Mathew, J., Kumar, A.,
Dathan, M.L., and Pillai, S.K.: Low-dose 131I therapy in
differentiated thyroid cancer.
Thyroid Science, 5(10):1-5, 2010.
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