El-Hadaad, H., Akl, M., Youssef, A., Abo El-khier, M. (2022). Assessment of Different Radioactive Iodine Ablation Strategies in Intermediate and High Risk Papillary Thyroid Cancer. The Egyptian Journal of Hospital Medicine, 88(1), 2653-2660. doi: 10.21608/ejhm.2022.240914
Hend Ahmed El-Hadaad; Mohamed Farouk Akl; Abd El-Monem Mohamed Youssef; Mohamed Ali Abo El-khier. "Assessment of Different Radioactive Iodine Ablation Strategies in Intermediate and High Risk Papillary Thyroid Cancer". The Egyptian Journal of Hospital Medicine, 88, 1, 2022, 2653-2660. doi: 10.21608/ejhm.2022.240914
El-Hadaad, H., Akl, M., Youssef, A., Abo El-khier, M. (2022). 'Assessment of Different Radioactive Iodine Ablation Strategies in Intermediate and High Risk Papillary Thyroid Cancer', The Egyptian Journal of Hospital Medicine, 88(1), pp. 2653-2660. doi: 10.21608/ejhm.2022.240914
El-Hadaad, H., Akl, M., Youssef, A., Abo El-khier, M. Assessment of Different Radioactive Iodine Ablation Strategies in Intermediate and High Risk Papillary Thyroid Cancer. The Egyptian Journal of Hospital Medicine, 2022; 88(1): 2653-2660. doi: 10.21608/ejhm.2022.240914
Assessment of Different Radioactive Iodine Ablation Strategies in Intermediate and High Risk Papillary Thyroid Cancer
Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Mansoura University, Egypt
Abstract
Background: Papillary thyroid cancer (PTC) represents most of cases of differentiated thyroid cancers. Thyroidectomy followed by radioactive iodine (RAI) remnant ablation represent the cornerstone management of many intermediate and high-risk patients according to American Thyroid Association (ATA). Objective: This study aimed to evaluate the outcome of different used I131 ablation doses (80, 100 and 120 mCi) in intermediate and high-risk patients in our hospital and to analyze the predictors affecting RAI failure. Besides, survival analysis was conducted as a secondary objective of the study. Patients and Methods: This was a retrospective study conducted on 63 patients diagnosed as PTC at our hospital from January 2015 till February 2020. Our study involved only PTC pathology, mean age of 40.6 ± 13.4 years at diagnosis, and intermediate- and high-risk patients according to ATA initial risk stratification system, 2015. Results: Among the 63 patients included in this study (17 males and 46 females), 41 were classified as intermediate-risk, while 22 were classified as high-risk based on the ATA guideline. Overall RAI ablation success, in both groups, was observed in 43/63 (68.25%) patients. Moreover, it was achieved in 31/41 (75.6%) of intermediate-risk patients and in 12/22 (54.5%) high-risk patients. Pre-ablation stimulated Tg >1ng/ml was statistically significant negative predictor of ablation failure [P-value < 0.001, odd`s ratio 61.5, 95% CI (10.8-51.5)]. Conclusion: There was no statistically significant difference between success rates of I131 doses in intermediate- and high-risk groups. However, the failure rates were more after 120 mCi due to the associated more aggressive underlying disease, especially higher-risk patients so higher RAI activities are recommended for this risk group.
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