Diferansiye Tiroid Karsinomlarında Radyoaktif İyot Tedavisi
Özet
DTK’de RAİ tedavisi kararı klinik tecrübe gerektiren, en eski radyonüklid tedavi olup yararı tartışmasızken kılavuzlarda ortak karara bağlanamamış tartışmalı bazı alanlar mevcuttur. DTK’li hastalar heterojen bir hasta grubu olup RAİ tedavisi kararının nükleer tıp uzmanları başta olmak üzere genel cerrahi, patoloji, medikal onkoloji, radyasyon onkolojisi gibi pek çok branştan hekimle multidisipliner bir yaklaşımla ele alınan konseylerde verilmesi gerekir. Tüm tedavilerde olduğu gibi maksimum etkinlikte ve güvenli sınırda RAİ verilmelidir. Güncel kılavuzların net olarak orta-yüksek risk grubunda ve metastatik hastalığı olanlarda RAİ tedavisini kesinlikle önerdiği ancak düşük risk grubunda ise açık alanlar bıraktığı görülmektedir.
While the decision to treat RAI in DTC is the oldest radionuclide treatment that requires clinical experience and its benefit is indisputable, there are some controversial areas that have not been agreed upon in the guidelines. Patients with DTC are a heterogeneous patient group, and the decision on RAI treatment should be made in councils with a multidisciplinary approach with physicians from many branches, especially nuclear medicine specialists, general surgery, pathology, medical oncology, radition oncology. As with all treatments, RAI should be given with maximum effectiveness and within the safe limit. İt is seen that current guidelines clearly recommend RAI treatment in the medium- high risk group and those with metastatic disease, but leave open areas in the low risk group.
Referanslar
Surveillance, Epidemiology, and End Results Program. Cancer stat facts: Thyroid Cancer. Bethesda, MD:National Cancer Institute;2021. Accessed on March 7, 2022.
SNMMI Procedure Standard/EANM Practice Guideline for Nuclear Medicine Evaluation and Therapy of Differentiated Thyroid Cancer: Abbreviated Version Journal of Nuclear Medicine June 2022, 63 (6) 15N-35N
Seethala, R.R.; Asa, S.L.; Carty, S.E.; Hodak, S.P.; McHugh, J.B.; Richardson, M.S.; Shah, J.; Thompson, L.D.R.; Nikiforov, Y.E. For the Members of the Cancer Committee, College of American Pathologists. Protocol for the Examination of Specimens From Patients With Carcinomas of the Thyroid Gland, Based on AJCC/UICC TNM, 7th edition. Version: Thyroid 3.2.0.0.
Rossi E, Fadda G. Pathology and immunohistochemistry in thyroid tumors. In: Atlas of Thyroid and Neuroendocrine Tumor Markers. Giovanella L, ed. New York; NY: Springer International Publishing; 2018:3–12
Van Nostrand D. The benefits and risks of I-131 therapy in patients with well-differentiated thyroid cancer. Thyroid.2009;19(12):1381–1391
Tuttle RM, Ahuja S, Avram AM, et al. Controversies, consensus, and collaboration in the use of 131I therapy in differentiated thyroid cancer: A joint statement from the American Thyroid Association, the European Association of Nuclear Medicine, the Society of Nuclear Medicine and Molecular Imaging, and the European Thyroid Association. Thyroid. 2019;29(4):461–470
Current Guidelines for Postoperative Treatment and Follow-Up of Well Differentiated Thyroid Cancer Surg Oncol Clin N Am 25 (2016) 41–59
Thyroid Carcinoma, Version 2.2022, NCCN Clinical Practice Guidelines in Oncology Journal of the National Comprehensive Cancer Network 2022;20(8):925–951
Guidelines for radioiodine therapy of differentiated thyroid cancer Eur J Nucl Med Mol Imaging DOI 10.1007/s00259-008-0883-1
2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer THYROID Volume 26, Number 1, 2016 American Thyroid Association Mary Ann Liebert, Inc.
Sunghwan Suh, Tae Sik Goh, Yun Hak Kim, Sae-Ock Oh, Kyoungjune Pak, Ju Won Seok, In Joo Kim, Development and Validation of a Risk Scoring System Derived from Meta-Analyses of Papillary Thyroid Cancer, Endocrinol Metab 2020;35:435-442
Benedikt Schmidbauer, Karin Menhart, Dirk Hellwig and Jirka Grosse, Differentiated Thyroid Cancer Treatment: State of the Art, Int. J. Mol. Sci. 2017, 18, 1292;
Salvatori M, Perotti G, Villani MF, et al. Determining the appropriate time of execution of an I-131 post-therapy whole-body scan: comparison between early and late imaging. Nucl Med Commun. 2013;34(9):900–908.
Alzahrani et al, Frequency and predictive factors of malignancy in residual thyroid tissue and cervical lymph nodes after partial thyroidectomy for differentiated thyroid cancer, Surgery 2002;131:443-9
Hocevar M, Auersperg M, Stanovnik L. The dynamics of serum thyroglobulin elimination from the body after thyroid surgery. Eur J Surg Oncol. 1997;23(3): 208–210
Mazzaferri EL, Kloos RT. Clinical review 128: Current approaches to primary therapy for papillary and follicular thyroid cancer. J Clin Endocrinol Metab. 2001;86(4):1447–1463
Spencer CA. Clinical review: Clinical utility of thyroglobulin antibody (TgAb) measurements for patients with differentiated thyroid cancers (DTC). J Clin Endocrinol Metab. 2011;96(12):3615–3627
Sebastiano Filetti, M.D., PTC Study Group Clinical aggressiveness and long-term outcome in patients with papillary thyroid cancer and circulating anti-thyroglobulin autoantibodies
Garcilaso Riesco-Eizaguirre1,2 and Pilar Santisteban1, A perspective view of sodium iodide symporter research and its clinical implications, European Journal of Endocrinology (2006) 155 495–512
Morari EC, Marcello MA, Guilhen AC, Cunha LL, Latuff P, Soares FA, Vassallo J, Ward LS. Use of sodium iodide symporter expression in differentiated thyroid carcinomas Clin Endocrinol (Oxf). 2011 Aug;75(2):247-54
Kim S, Chung JK, Min HS, Kang JH, Park DJ, Jeong JM, Lee DS, Park SH, Cho BY, Lee S, Lee MC. Expression Patterns of Glucose Transporter-1 Gene and Thyroid Specific Genes in Human Papillary Thyroid Carcinoma, Nucl Med Mol Imaging (2014) 48:91–97
Choudhury PS, Gupta M, Differentiated thyroid cancer theranostics: radioiodine and beyond,The British journal of radiology 91(1091):20180136
Sungeun Kim, June-Key Chung, Hae-Sook Min, Joo-Hyun Kang, Do Joon Park, Jae Min Jeong, Dong Soo Lee, Sung-Hwae Park, Bo Youn Cho, Sinae Lee, Myung Chul Lee, Expression Patterns of Glucose Transporter-1 Gene and Thyroid Specific Genes in Human Papillary Thyroid Carcinoma, Nucl Med Mol Imaging (2014) 48:91–97
Seyfettin Ilgan. Risk Sınıflarına Göre I-131 Kullanımı Nucl Med Semin 2021;7:1-32
Juan Xiao, CanhuaYun, Jingjia Cao, Shouluan Ding, Chunchun Shao, LinaWang, Fengyan Huang, Hongying Jia, A pre ablative thyroid stimulating hormone with 30–70 mIU/L achieves better response to initial radioiodine remnant ablation in diferentiated thyroid carcinoma patients, Scientifc Reports (2021) 11:1348
Lawal IO, Nyakale NE, Harry LM, et al. Higher preablative serum thyroid-stimulating hormone level predicts radioiodine ablation effectiveness in patients with differentiated thyroid carcinoma. Nucl Med Commun. 2017;38(3):222–227
World Health Organization.Urinary Iodine Concentrations for Determining Iodine Status in Populations.Vitamin and Mineral Nutrition Information System.Technical Report.Geneva, Switzerland:World Health Organization; 2013.
Sohn SY, Choi JY, Jang HW, et al. Association between excessive urinary iodine excretion and failure of radioactive iodine thyroid ablation in patients with papillary thyroid cancer. Thyroid. 2013;23(6):741–747
Bartel Chair TB, Magerefteh S, Avram AM, et al. SNMMI Procedure Standard for Scintigraphy for Differentiated Thyroid Cancer. J Nucl Med Technol. 2020; 48(3):202–209
ThyCa: Thyroid Cancer Survivors’ Association. Low-Iodine Cookbook. 9th ed. Olney, MD: ThyCa: Thyroid Cancer Survivors’ Association; 2020. Available from: https://www.thyca.org/download/document/231/Cookbook. Accessed on March 11, 2022
Giovanella L, Duntas LH. Management of endocrine disease: The role of rhTSH in the management of differentiated thyroid cancer: Pros and cons. Eur J Endocrinol. 2019;181(4):R133–R145.
Giovanella L, Treglia G, Sadeghi R, Trimboli P, Ceriani L, Verburg FA. Unstimulated highly sensitive thyroglobulin in follow-up of differentiated thyroid cancer patients: a metaanalysis. J Clin Endocrinol Metab 2014;99:440-447.
Prabhu M, Samson S, Reddy A, et al. Role of Preablative Stimulated Thyroglobulin in Prediction of Nodal and Distant Metastasis on Iodine Whole-Body Scan. Indian J Nucl Med 2018;33:93-98.
Prpić M, Franceschi M, Romić M, Jukić T, Kusić Z. Thyroglobulin as a tumor marker in differentiated thyroid cancer– clinical considerations. Acta Clin Croat 2018;57:518-526
Burak et al. Tiroid Kanseri ve Tiroglobulin Nucl Med Semin 2021;7:47-54 DOI:10.4274/nts.galenos.2021.0003
Mourão GF, Rosario PW, Calsolari MR. Low postoperative nonstimulated thyroglobulin as a criterion to spare radioiodine ablation. Endocr Relat Cancer 2016;23:47-52.
Rosario PW, Mourão GF, Siman TL, Calsolari MR. A low postoperative nonstimulated serum thyroglobulin level excludes the presence of persistent disease in low-risk papillary thyroid cancer patients: implication for radioiodine indication. Clin Endocrinol (Oxf) 2015;83:957-961.
Spencer CA, Feingold KR, Anawalt B, et al. Assay of thyroid hormones and related substances. J Clin Endocrinol Metabol 2017
Baloch Z, Carayon P, Conte-Devolx B et al. Laboratory support for the diagnosis of thyroid disease: Thyroglobulin. The National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines (NACB) 2002;55-65
Kim SJ, Lee SW, Pak K, Shim SR. Diagnostic performance of PET in thyroid cancer with elevated anti-Tg Ab.Endocr Relat Cancer 2018;25:643-652.
Çınar ve Arslan. Diferensiye Tiroid Kanseri ve Antitiroglobulin Yüksekliği Nucl Med Semin 2021;7:63-69
Demir et al. Pre-ablative Thyroglobulin for Prediction of Metastasis, Mol Imaging Radionucl Ther 2019;28:21-26
Donohoe KJ, Aloff J, Avram AM, et al. Appropriate use criteria for nuclear medicine in the evaluation and treatment of differentiated thyroid cancer. J Nucl Med. 2020;61(3):375–396
Sürer Budak E, Aydın F. Diferansiye tiroid kanserlerinde RAI-131 tedavisi. Çelen YZ, editör. Tiroid ve Paratiroid Bezi Hastalıklarının Tanı ve Tedavisinde Nükleer Tıp Uygulamaları. 1. Baskı. Ankara: Türkiye Klinikleri; 2021. p.19-30
Mehmet Reyhan. I-131 Tedavisinde Yan Etkiler ve Hasta Yönetimi. Nucl Med Semin 2021;7:101-112
Michael Lassmann & Heribert Hänscheid & Carlo Chiesa & Cecilia Hindorf & Glenn Flux & Markus Luster, EANM Dosimetry Committee series on standard operational procedures for pre-therapeutic dosimetry I: blood and bone marrow dosimetry in differentiated thyroid cancer therapy, Eur J Nucl Med Mol Imaging (2008) 35:1405–1412
H R Maxon d, E E Englaro, S R Thomas, V S Hertzberg, J D Hinnefeld, L S Chen, H Smith, D Cummings, M D Aden, Radioiodine-131 therapy for well-differentiated thyroid cancer a quantitative radiation dosimetric approach: outcome and validation in 85 patients, The Journal of Nuclear Medicine Vol.33 No. 6 June 1992
Mallika Bhat, Matty Mozzor, Savneek Chugh, Vamsi Buddharaju, Monica Schwarcz and Guy Valiquette, Dosing of radioactive iodine in end-stage renal disease patient with thyroid cancer, endocrinology,diabetes and metobolism case reports, ID: 17-0111; November 2017
F.A. Verburg et al. Radioactive iodine (RAI) therapy for metastatic differentiated thyroid cancer, Best Practice & Research Clinical Endocrinology & Metabolism 31 (2017) 279-290
Referanslar
Surveillance, Epidemiology, and End Results Program. Cancer stat facts: Thyroid Cancer. Bethesda, MD:National Cancer Institute;2021. Accessed on March 7, 2022.
SNMMI Procedure Standard/EANM Practice Guideline for Nuclear Medicine Evaluation and Therapy of Differentiated Thyroid Cancer: Abbreviated Version Journal of Nuclear Medicine June 2022, 63 (6) 15N-35N
Seethala, R.R.; Asa, S.L.; Carty, S.E.; Hodak, S.P.; McHugh, J.B.; Richardson, M.S.; Shah, J.; Thompson, L.D.R.; Nikiforov, Y.E. For the Members of the Cancer Committee, College of American Pathologists. Protocol for the Examination of Specimens From Patients With Carcinomas of the Thyroid Gland, Based on AJCC/UICC TNM, 7th edition. Version: Thyroid 3.2.0.0.
Rossi E, Fadda G. Pathology and immunohistochemistry in thyroid tumors. In: Atlas of Thyroid and Neuroendocrine Tumor Markers. Giovanella L, ed. New York; NY: Springer International Publishing; 2018:3–12
Van Nostrand D. The benefits and risks of I-131 therapy in patients with well-differentiated thyroid cancer. Thyroid.2009;19(12):1381–1391
Tuttle RM, Ahuja S, Avram AM, et al. Controversies, consensus, and collaboration in the use of 131I therapy in differentiated thyroid cancer: A joint statement from the American Thyroid Association, the European Association of Nuclear Medicine, the Society of Nuclear Medicine and Molecular Imaging, and the European Thyroid Association. Thyroid. 2019;29(4):461–470
Current Guidelines for Postoperative Treatment and Follow-Up of Well Differentiated Thyroid Cancer Surg Oncol Clin N Am 25 (2016) 41–59
Thyroid Carcinoma, Version 2.2022, NCCN Clinical Practice Guidelines in Oncology Journal of the National Comprehensive Cancer Network 2022;20(8):925–951
Guidelines for radioiodine therapy of differentiated thyroid cancer Eur J Nucl Med Mol Imaging DOI 10.1007/s00259-008-0883-1
2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer THYROID Volume 26, Number 1, 2016 American Thyroid Association Mary Ann Liebert, Inc.
Sunghwan Suh, Tae Sik Goh, Yun Hak Kim, Sae-Ock Oh, Kyoungjune Pak, Ju Won Seok, In Joo Kim, Development and Validation of a Risk Scoring System Derived from Meta-Analyses of Papillary Thyroid Cancer, Endocrinol Metab 2020;35:435-442
Benedikt Schmidbauer, Karin Menhart, Dirk Hellwig and Jirka Grosse, Differentiated Thyroid Cancer Treatment: State of the Art, Int. J. Mol. Sci. 2017, 18, 1292;
Salvatori M, Perotti G, Villani MF, et al. Determining the appropriate time of execution of an I-131 post-therapy whole-body scan: comparison between early and late imaging. Nucl Med Commun. 2013;34(9):900–908.
Alzahrani et al, Frequency and predictive factors of malignancy in residual thyroid tissue and cervical lymph nodes after partial thyroidectomy for differentiated thyroid cancer, Surgery 2002;131:443-9
Hocevar M, Auersperg M, Stanovnik L. The dynamics of serum thyroglobulin elimination from the body after thyroid surgery. Eur J Surg Oncol. 1997;23(3): 208–210
Mazzaferri EL, Kloos RT. Clinical review 128: Current approaches to primary therapy for papillary and follicular thyroid cancer. J Clin Endocrinol Metab. 2001;86(4):1447–1463
Spencer CA. Clinical review: Clinical utility of thyroglobulin antibody (TgAb) measurements for patients with differentiated thyroid cancers (DTC). J Clin Endocrinol Metab. 2011;96(12):3615–3627
Sebastiano Filetti, M.D., PTC Study Group Clinical aggressiveness and long-term outcome in patients with papillary thyroid cancer and circulating anti-thyroglobulin autoantibodies
Garcilaso Riesco-Eizaguirre1,2 and Pilar Santisteban1, A perspective view of sodium iodide symporter research and its clinical implications, European Journal of Endocrinology (2006) 155 495–512
Morari EC, Marcello MA, Guilhen AC, Cunha LL, Latuff P, Soares FA, Vassallo J, Ward LS. Use of sodium iodide symporter expression in differentiated thyroid carcinomas Clin Endocrinol (Oxf). 2011 Aug;75(2):247-54
Kim S, Chung JK, Min HS, Kang JH, Park DJ, Jeong JM, Lee DS, Park SH, Cho BY, Lee S, Lee MC. Expression Patterns of Glucose Transporter-1 Gene and Thyroid Specific Genes in Human Papillary Thyroid Carcinoma, Nucl Med Mol Imaging (2014) 48:91–97
Choudhury PS, Gupta M, Differentiated thyroid cancer theranostics: radioiodine and beyond,The British journal of radiology 91(1091):20180136
Sungeun Kim, June-Key Chung, Hae-Sook Min, Joo-Hyun Kang, Do Joon Park, Jae Min Jeong, Dong Soo Lee, Sung-Hwae Park, Bo Youn Cho, Sinae Lee, Myung Chul Lee, Expression Patterns of Glucose Transporter-1 Gene and Thyroid Specific Genes in Human Papillary Thyroid Carcinoma, Nucl Med Mol Imaging (2014) 48:91–97
Seyfettin Ilgan. Risk Sınıflarına Göre I-131 Kullanımı Nucl Med Semin 2021;7:1-32
Juan Xiao, CanhuaYun, Jingjia Cao, Shouluan Ding, Chunchun Shao, LinaWang, Fengyan Huang, Hongying Jia, A pre ablative thyroid stimulating hormone with 30–70 mIU/L achieves better response to initial radioiodine remnant ablation in diferentiated thyroid carcinoma patients, Scientifc Reports (2021) 11:1348
Lawal IO, Nyakale NE, Harry LM, et al. Higher preablative serum thyroid-stimulating hormone level predicts radioiodine ablation effectiveness in patients with differentiated thyroid carcinoma. Nucl Med Commun. 2017;38(3):222–227
World Health Organization.Urinary Iodine Concentrations for Determining Iodine Status in Populations.Vitamin and Mineral Nutrition Information System.Technical Report.Geneva, Switzerland:World Health Organization; 2013.
Sohn SY, Choi JY, Jang HW, et al. Association between excessive urinary iodine excretion and failure of radioactive iodine thyroid ablation in patients with papillary thyroid cancer. Thyroid. 2013;23(6):741–747
Bartel Chair TB, Magerefteh S, Avram AM, et al. SNMMI Procedure Standard for Scintigraphy for Differentiated Thyroid Cancer. J Nucl Med Technol. 2020; 48(3):202–209
ThyCa: Thyroid Cancer Survivors’ Association. Low-Iodine Cookbook. 9th ed. Olney, MD: ThyCa: Thyroid Cancer Survivors’ Association; 2020. Available from: https://www.thyca.org/download/document/231/Cookbook. Accessed on March 11, 2022
Giovanella L, Duntas LH. Management of endocrine disease: The role of rhTSH in the management of differentiated thyroid cancer: Pros and cons. Eur J Endocrinol. 2019;181(4):R133–R145.
Giovanella L, Treglia G, Sadeghi R, Trimboli P, Ceriani L, Verburg FA. Unstimulated highly sensitive thyroglobulin in follow-up of differentiated thyroid cancer patients: a metaanalysis. J Clin Endocrinol Metab 2014;99:440-447.
Prabhu M, Samson S, Reddy A, et al. Role of Preablative Stimulated Thyroglobulin in Prediction of Nodal and Distant Metastasis on Iodine Whole-Body Scan. Indian J Nucl Med 2018;33:93-98.
Prpić M, Franceschi M, Romić M, Jukić T, Kusić Z. Thyroglobulin as a tumor marker in differentiated thyroid cancer– clinical considerations. Acta Clin Croat 2018;57:518-526
Burak et al. Tiroid Kanseri ve Tiroglobulin Nucl Med Semin 2021;7:47-54 DOI:10.4274/nts.galenos.2021.0003
Mourão GF, Rosario PW, Calsolari MR. Low postoperative nonstimulated thyroglobulin as a criterion to spare radioiodine ablation. Endocr Relat Cancer 2016;23:47-52.
Rosario PW, Mourão GF, Siman TL, Calsolari MR. A low postoperative nonstimulated serum thyroglobulin level excludes the presence of persistent disease in low-risk papillary thyroid cancer patients: implication for radioiodine indication. Clin Endocrinol (Oxf) 2015;83:957-961.
Spencer CA, Feingold KR, Anawalt B, et al. Assay of thyroid hormones and related substances. J Clin Endocrinol Metabol 2017
Baloch Z, Carayon P, Conte-Devolx B et al. Laboratory support for the diagnosis of thyroid disease: Thyroglobulin. The National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines (NACB) 2002;55-65
Kim SJ, Lee SW, Pak K, Shim SR. Diagnostic performance of PET in thyroid cancer with elevated anti-Tg Ab.Endocr Relat Cancer 2018;25:643-652.
Çınar ve Arslan. Diferensiye Tiroid Kanseri ve Antitiroglobulin Yüksekliği Nucl Med Semin 2021;7:63-69
Demir et al. Pre-ablative Thyroglobulin for Prediction of Metastasis, Mol Imaging Radionucl Ther 2019;28:21-26
Donohoe KJ, Aloff J, Avram AM, et al. Appropriate use criteria for nuclear medicine in the evaluation and treatment of differentiated thyroid cancer. J Nucl Med. 2020;61(3):375–396
Sürer Budak E, Aydın F. Diferansiye tiroid kanserlerinde RAI-131 tedavisi. Çelen YZ, editör. Tiroid ve Paratiroid Bezi Hastalıklarının Tanı ve Tedavisinde Nükleer Tıp Uygulamaları. 1. Baskı. Ankara: Türkiye Klinikleri; 2021. p.19-30
Mehmet Reyhan. I-131 Tedavisinde Yan Etkiler ve Hasta Yönetimi. Nucl Med Semin 2021;7:101-112
Michael Lassmann & Heribert Hänscheid & Carlo Chiesa & Cecilia Hindorf & Glenn Flux & Markus Luster, EANM Dosimetry Committee series on standard operational procedures for pre-therapeutic dosimetry I: blood and bone marrow dosimetry in differentiated thyroid cancer therapy, Eur J Nucl Med Mol Imaging (2008) 35:1405–1412
H R Maxon d, E E Englaro, S R Thomas, V S Hertzberg, J D Hinnefeld, L S Chen, H Smith, D Cummings, M D Aden, Radioiodine-131 therapy for well-differentiated thyroid cancer a quantitative radiation dosimetric approach: outcome and validation in 85 patients, The Journal of Nuclear Medicine Vol.33 No. 6 June 1992
Mallika Bhat, Matty Mozzor, Savneek Chugh, Vamsi Buddharaju, Monica Schwarcz and Guy Valiquette, Dosing of radioactive iodine in end-stage renal disease patient with thyroid cancer, endocrinology,diabetes and metobolism case reports, ID: 17-0111; November 2017
F.A. Verburg et al. Radioactive iodine (RAI) therapy for metastatic differentiated thyroid cancer, Best Practice & Research Clinical Endocrinology & Metabolism 31 (2017) 279-290
