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Empiric Radioactive Iodine Dosing Regimens Frequently Exceed Maximum Tolerated Activity Levels in Elderly Patients with Thyroid Cancer

R. Michael Tuttle1, Rebecca Leboeuf1, Richard J. Robbins1, Rebecca Qualey1, Keith Pentlow2, Steven M. Larson2 and Chee Y. Chan1

1 Endocrinology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York; and 2 Nuclear Medicine Service, Departments of Medicine and Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York


Figure 1
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  		FIGURE 1.  MTA distribution for the 328 patients. Mean MTA is 15.3 ± 6.4 GBq (414 ± 173 mCi).

 

Figure 2
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  		FIGURE 2.  MTA cutoff points on bar graph. Three percent of patients had MTA lower than 5.18 GBq (140 mCi), 8% had MTA lower than 7.4 GBq (200 mCi), and 19% had MTA lower than 9.25 GBq (250 mCi).

 

Figure 3
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  		FIGURE 3.  Mean MTA value (horizontal bars) according to age, with 95% confidence intervals (vertical bars). MTA showed no significant change until declining in seventh decade of life.

 

Figure 4
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  		FIGURE 4.  Percentage of patients (according to decade of life) in whom MTA exceeded empiric dosing. Empiric dose above 7.4 GBq (200 mCi) exceeded MTA in large proportion of patients more than 60 y old (14% of patients 60–69 y old and 22% of those 70–79 y old). Empiric dose of 9.25 GBq (250 mCi) would exceed MTA in 22% of patients 60–69 y old and in 50% of those 70 y old or older.

 




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