Long-term survival and low effective cumulative radioiodine doses to achieve remission in patients with 131Iodine-avid lung metastasis from differentiated thyroid cancer.
Clin Nucl Med
; 39(9): 784-90, 2014 Sep.
Article
en En
| MEDLINE
| ID: mdl-24999689
ABSTRACT
OBJECTIVE:
To evaluate long-term survival and response to RAI treatment in patients with differentiated thyroid cancer (DTC) and 131Iodine-avid metastatic lung disease. PATIENTS ANDMETHODS:
A retrospective review of 639 DTC patients followed-up at the Hospital de Clínicas, Buenos Aires, Argentina, showed that 42 (6%) patients had lung metastasis, and 24 patients were included for analysis.RESULTS:
Seventeen were women, and 7 were men (FM=2.41). Eighteen patients (75%) had PTC, and 6 (25%) had FTC. The median age at diagnosis was older than 45 years in 50%, and the median follow-up was 13 years. Good response to treatment (GRT no evidence of disease or biochemical persistence without structural correlate) was observed in 46% of patients (all with diffuse postdose radioiodine uptake and no structural images higher than 1 cm in diameter); and 21% patients died from disseminated lung metastasis. Overall survival at 5 and 10 years was 100% and 88.4%, respectively. The Cox proportional hazard ratio showed that extrathyroidal invasion, positive uptake of 18-FDG, and metachronous diagnosis of the lung metastasis were variables that significantly predicted death. Those patients who had a GRT did with a mean effective cumulative RAI dose of 457.3±29.7 mCi 131I (range, 300-600 mCi 131I).CONCLUSIONS:
Lung metastasis showed a slow progression with a high long-term overall survival. The presence of synchronous lung metastasis, the absence of nodules larger than 1 cm, and the lack of uptake of FDG were predictive factors for an early response to treatment with RAI cumulative doses lower than 600 mCi 131I.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Neoplasias de la Tiroides
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Carcinoma Papilar Folicular
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Radiofármacos
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Radioisótopos de Yodo
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Neoplasias Pulmonares
Tipo de estudio:
Evaluation_studies
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Prognostic_studies
Límite:
Adolescent
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Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Clin Nucl Med
Año:
2014
Tipo del documento:
Article
País de afiliación:
Argentina