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European Journal of Nuclear Medicine and Molecular Imaging

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01.07.2011 | Original Article

Success of the postoperative ¹³¹I therapy in young Belarusian patients with differentiated thyroid cancer after Chernobyl depends on the radiation absorbed dose to the blood and the thyroglobulin level

verfasst von: Heribert Hänscheid, Frederik Anton Verburg, Johannes Biko, Stefanie Dießl, Yuri E. Demidchik, Valentina Drozd, Christoph Reiners

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 7/2011

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Abstract

Purpose

Differentiated thyroid carcinoma (DTC) in children and young adults is rare but often aggressive and in an advanced stage at diagnosis. In a cohort of young Belarusian patients with advanced DTC after Chernobyl we retrospectively studied parameters influencing the success of the postoperative ¹³¹I therapy.

Methods

Included in the study were 136 patients (83 female, 53 male; median age 14.3 years, range 9.4–22.8 years) who had had total thyroidectomy in Belarus and subsequent ¹³¹I therapy and follow-up in Germany. Of the 136 patients, 34 were classified as M1 and 102 as M0 (N0 1, N1 101). The median weight-adjusted ¹³¹I activity administered after thyroid hormone withdrawal was 52 MBq/kg (range 24–74 MBq/kg). TNM stage, gender, administered activity, whole-body residence time and blood dose during ablation, Tg and TSH levels, date, and age at time of treatment were tested for their effect on the rate of complete remission (CR). CR was defined as a negative scan and a stimulated Tg level of <1 ng/ml at follow-up.

Results

CR was observed in 1 of 34 M1 and in 51 of 102 M0 patients after the first treatment. Multivariate analysis in the M0 group identified the Tg level (P < 0.0001 for log(Tg)) and the radiation absorbed dose to the blood (P < 0.001) as independent determinants; all other parameters were unimportant (P > 0.3). The regression model was able to correctly predict CR in 82 of 102 patients (80.4%).

Conclusion

In children and young adults with advanced DTC, the rate of CR after postoperative ¹³¹I therapy is dependent on the preablative Tg level and the radiation absorbed dose to the blood. Though the present results must be confirmed in a prospective study, they imply that preablative dosimetry may improve rates of CR.

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Titel: Success of the postoperative 131I therapy in young Belarusian patients with differentiated thyroid cancer after Chernobyl depends on the radiation absorbed dose to the blood and the thyroglobulin level
verfasst von: Heribert Hänscheid
Frederik Anton Verburg
Johannes Biko
Stefanie Dießl
Yuri E. Demidchik
Valentina Drozd
Christoph Reiners
Publikationsdatum: 01.07.2011
Verlag: Springer-Verlag
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 7/2011
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-011-1788-y

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

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