Current controversies in the initial post-surgical radioactive iodine therapy for thyroid cancer: A narrative review

Ralph Blumhardt, Ely A. Wolin, William T. Phillips, Umber A. Salman, Ronald C. Walker, Brendan C. Stack, Darlene Metter

Research output: Contribution to journalReview article

30 Scopus citations

Abstract

Differentiated thyroid cancer (DTC) is the most common endocrine malignancy and the fifth most common cancer in women. DTC therapy requires a multimodal approach, including surgery,which is beyond the scope of this paper. However, for over 50 years, the post operative management of the DTC post-thyroidectomy patient has included radioactive iodine (RAI) ablation and/or therapy. Before 2000, a typical RAI post-operative dose recommendation was 100 mCi for remnant ablation, 150 mCi for locoregionalnodal disease, and 175-200 mCi for distant metastases. Recent recommendations have been made to decrease the dose in order to limit the perceived adverse effects of RAI including salivary gland dysfunction and inducing secondary primary malignancies. A significant controversy has thus arisen regarding the use of RAI, particularly in the management of the low-risk DTC patient. This debate includes the definition of the low-risk patient, RAI dose selection, and whether or not RAI is needed in all patients. To allow the reader to forman opinion regarding post-operative RAI therapy in DTC, a literature review of the risks and benefits is presented.

Original languageEnglish (US)
Pages (from-to)R473-R484
JournalEndocrine-Related Cancer
Volume21
Issue number6
DOIs
StatePublished - Dec 1 2014

Keywords

  • 131I
  • Radioactive iodine therapy
  • Thyroid cancer
  • Thyroid cancer resistance
  • Thyroid cancer staging

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Oncology
  • Endocrinology
  • Cancer Research

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