RT Journal Article
SR Electronic
T1 Comparison of Empiric Versus Whole-Body/-Blood Clearance Dosimetry–Based Approach to Radioactive Iodine Treatment in Patients with Metastases from Differentiated Thyroid Cancer
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 717
OP 722
DO 10.2967/jnumed.116.179606
VO 58
IS 5
A1 Désirée Deandreis
A1 Carole Rubino
A1 Hernan Tala
A1 Sophie Leboulleux
A1 Marie Terroir
A1 Eric Baudin
A1 Steve Larson
A1 James A. Fagin
A1 Martin Schlumberger
A1 R. Michael Tuttle
YR 2017
UL http://jnm.snmjournals.org/content/58/5/717.abstract
AB The optimal management of radioactive iodine (RAI) treatment in patients with metastatic thyroid cancer (TC) is still a matter of debate. Methods: We retrospectively analyzed 352 patients with RAI-avid metastatic well-differentiated TC treated with 131I by an empiric fixed activity of 3.7 GBq at Gustave Roussy (GR, n = 231) or by personalized activity (2.7–18.6 GBq) based on whole-body/-blood clearance (WB/BC) dosimetry at Memorial Sloan Kettering Cancer Center (MSKCC, n = 121). The primary endpoint was to compare overall survival (OS) in the 2 groups of patients by log-rank test. Results: Patients received a median cumulative activity of 14.8 GBq at GR and 24.2 GBq at MSKCC (P < 0.0001). The median follow-up after the diagnosis of metastases was 7.2 y (0.4−31 y). Five-year OS was 86.8% and 78.8% for patients treated at GR and at MSKCC, respectively (P < 0.01). However, there was no statistical difference in OS after correction for sex, age at the diagnosis of distant metastases, metastases site, and metastases extension between the 2 centers (P = 0.16). OS at 5 y was 96% and 96% for patients younger than 40 y with micrometastases, 70% and 65% for patients older than 40 y with macrometastases or multiple metastases, and 92% and 87% for younger patients with macrometastases or older patients with micrometastases treated at GR and MSKCC, respectively (P = not significant). Conclusion: Routine use of WB/BC dosimetry without lesional dosimetry provided no OS advantage when compared with empiric fixed RAI activity in the management of thyroid cancer patients with RAI-avid distant metastases.