TABLE 5

Additional Considerations Before Assignment of Radioiodine-Refractory Disease Status (161)

  • Appropriate preparation of patient for diagnostic and/or posttherapy RAI scan (39,177)

  • Results of the diagnostic scan

  • Results of the posttherapy scan

  • Response to the last 131I therapy

  • Criteria for progression

  • Time to progression

  • Activity of 131I administered for the last 131I therapy

  • Total accumulative activity of 131I administered

  • Objectives of 131I therapy (e.g., cure, progression-free survival, overall survival, palliation)

  • Location and number of metastases. They may be radioiodine avid, but perhaps focal direct therapy (e.g., surgery, XRT, cryotherapy, etc.) may be more effective, warranted, or desired.

  • Type, frequency, and severity of side effects of 131I therapy

  • Patient’s desires (e.g., patient is a “minimalist” or “maximalist”) (200)