Low versus high 131I therapeutic effectiveness for differentiated thyroid cancer with intermediate risk of recurrence
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Abstract
High 131I is recommended for the treatment of differentiated thyroid cancer (DTC) with the intermediate-to-high risk of recurrence. Since the lower 131I gives the lower side effects, the lower chance of secondary cancer and the lower radiation hazard, reduction of 131I doses with similar clinical outcomes is challenging. The aim of this study was to compare and assess the clinical outcome of low (30 mCi) and high (150 mCi) 131I treatment for DTC with the intermediate risk of recurrence. All DTC with the intermediate risk of recurrence between 2012 and 2019 were consecutively included. They were excluded if they had the blood tests of Thyroid-stimulating hormone (TSH) of ≤ 25 µIU/L on the day before 131I oral administration or during the first diagnostic total body study or having received an injection of thyrotropin alfa, having previous treatment for thyroid cancer except for surgery, and having incomplete medical records. Six hundred sixty-six patients with DTC with the intermediate risk of recurrence were included, 50 were in the low 131I and 616 were in the high 131I. Patients in the high 131I showed a higher odd of remission with an adjusted odds ratio of 1.96 (95% CI: 1.01 to 3.81; p = 0.048), compared to the low 131I. Therapeutic effectiveness of the low 131I for DTC with the intermediate risk of recurrence was lower than that of the high131I. Therefore, use of low 131I in patients who were in the misclassification of risk stratification of low-risk changing to intermediate-risk tended to be uncured.
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