HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Dorn, R. Articles by Gulec, S. A. Search for Related Content PubMed PubMed Citation Articles by Dorn, R. Articles by Gulec, S. A.

Dosimetry-Guided Radioactive Iodine Treatment in Patients with Metastatic Differentiated Thyroid Cancer: Largest Safe Dose Using a Risk-Adapted Approach

¹ Department of Nuclear Medicine, Augsburg Clinic, Augsburg, Germany
² Department of Medical Physics, Augsburg Clinic, Augsburg, Germany
³ Nuclear Medicine Service, University Community Hospital, Tampa, Florida
⁴ John Wayne Cancer Institute, Santa Monica, California

This study is a retrospective analysis of 124 differentiated thyroid cancer patients who underwent dosimetric evaluation using MIRD methodology over a period of 15 y. The objectives of the study were to demonstrate the clinical use of dosimetry-guided radioactive iodine ([RAI] ¹³¹I) treatment and the safe and effective application of a 3-Gy bone marrow (BM) dose in patients with differentiated thyroid cancer. Methods: Tumor and BM dose estimates were obtained. The administered activity that would deliver a maximum safe dose to the organ at risk (red BM or lungs) was determined as well as the resulting doses to the metastases. The clinical benefit of an individual RAI treatment was predicted on the basis of the dose estimates and the expected therapeutic response. Each patient’s response to treatment was assessed clinically and by monitoring the hematologic profile. Results: One hundred twenty-four patients underwent 187 dosimetric evaluations. One hundred four RAI treatments were performed. A complete response at metastatic deposits was attained with absorbed doses of >100 Gy. No permanent BM suppression was observed in patients who received absorbed doses of <3 Gy to BM. The maximum administered dose was 38.5 GBq (1,040 mCi) with the BM dose limitation. Conclusion: Dosimetry-guided RAI treatment allows administration of the maximum possible RAI dose to achieve the maximum therapeutic benefit. Estimation of tumor dose rates helps to determine the curative versus the palliative intent of the therapy.

Key Words: thyroid cancer • ¹³¹I therapy • largest safe dose • dosimetry

This article has been cited by other articles:

				G. Sgouros, H. Song, P. W. Ladenson, and R. L. Wahl Lung Toxicity in Radioiodine Therapy of Thyroid Carcinoma: Development of a Dose-Rate Method and Dosimetric Implications of the 80-mCi Rule J. Nucl. Med., December 1, 2006; 47(12): 1977 - 1984. [Abstract] [Full Text] [PDF]

				H. Song, B. He, A. Prideaux, Y. Du, E. Frey, W. Kasecamp, P. W. Ladenson, R. L. Wahl, and G. Sgouros Lung Dosimetry for Radioiodine Treatment Planning in the Case of Diffuse Lung Metastases J. Nucl. Med., December 1, 2006; 47(12): 1985 - 1994. [Abstract] [Full Text] [PDF]

				J. M. Woolfenden Thyroid Stunning Revisited J. Nucl. Med., September 1, 2006; 47(9): 1403 - 1405. [Full Text] [PDF]

				H. Hanscheid, M. Lassmann, M. Luster, S. R. Thomas, F. Pacini, C. Ceccarelli, P. W. Ladenson, R. L. Wahl, M. Schlumberger, M. Ricard, et al. Iodine Biokinetics and Dosimetry in Radioiodine Therapy of Thyroid Cancer: Procedures and Results of a Prospective International Controlled Study of Ablation After rhTSH or Hormone Withdrawal J. Nucl. Med., April 1, 2006; 47(4): 648 - 654. [Abstract] [Full Text] [PDF]

				B Jarzab, D Handkiewicz-Junak, and J Wloch Juvenile differentiated thyroid carcinoma and the role of radioiodine in its treatment: a qualitative review Endocr. Relat. Cancer, December 1, 2005; 12(4): 773 - 803. [Abstract] [Full Text] [PDF]

				R. J. Robbins and M. J. Schlumberger The Evolving Role of 131I for the Treatment of Differentiated Thyroid Carcinoma J. Nucl. Med., January 1, 2005; 46(1_suppl): 28S - 37S. [Abstract] [Full Text] [PDF]

				K. E. Britton Radioimmunotherapy of Non-Hodgkin's Lymphoma J. Nucl. Med., May 1, 2004; 45(5): 924 - 925. [Full Text] [PDF]

				S. K. Gerard, H. M. Park, and S. A. Gulec 131I Dosimetry and Thyroid Stunning J. Nucl. Med., December 1, 2003; 44(12): 2039 - 2040. [Full Text] [PDF]