title: Is it still worthwhile to treat bone metastases from differentiated thyroid carcinoma with radioactive iodine?
abstract: From 1964 to 1989, bone metastases were found in 28 of 600 patients operated on for differentiated thyroid carcinoma. Bone metastasis was the presenting symptom in 15 (54%) patients, was detected from the initial symptom in 4 (14.5%) patients, and occurred subsequently in 9 (32%) patients, with an average lag time of 4.5 years after surgical treatment. Pathological pattern of the thyroid cancer was follicular in 26 (93%) patients and papillary in 2 (7%) patients. Bone metastatic involvement was multiple in 21 (75%) patients and associated with other synchronous or metachronous distant metastases in 13 (46%) patients, especially in the lung (10 patients) or the brain (3 patients). The primary treatment of thyroid carcinoma was total thyroidectomy in all 28 patients, with additional modified neck dissection in 8 patients. All 15 patients presenting with symptoms had bone metastases demonstrated by x-ray studies. Six of the bone metastases only took up radioactive iodine 6 weeks after total thyroidectomy, as did 2 of 4 bone metastases detected at initial observation and 4 of 9 metachronous bone metastases. All 12 patients with functioning bone metastases were given radioactive iodine therapy; 4 of the metastases were surgically resected. Only 2 patients with bone metastases showed a complete response after an ablative dose of I-131; none of the metastases had been demonstrated by x-ray studies. Radioactive iodine therapy cures no more than 17% of patients with bone metastases taking up radioactive iodine and 7% of all patients with bone metastases. All patients cured of bone metastases were given radioactive iodine, either alone, or combined with other treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Department of General and Endocrine Surgery, CHUP Lille, France.
authors.forename: C A
authors.initials: CA
authors.lastname: Proye
authors.forename: D H
authors.initials: DH
authors.lastname: Dromer
authors.forename: B M
authors.initials: BM
authors.lastname: Carnaille
authors.forename: A J
authors.initials: AJ
authors.lastname: Gontier
authors.forename: A
authors.initials: A
authors.lastname: Goropoulos
authors.forename: P
authors.initials: P
authors.lastname: Carpentier
authors.forename: J
authors.initials: J
authors.lastname: Lefebvre
authors.forename: M
authors.initials: M
authors.lastname: Decoulx
authors.forename: J L
authors.initials: JL
authors.lastname: Wemeau
authors.forename: P
authors.initials: P
authors.lastname: Fossati
mesh_terms: D000230:Adenocarcinoma / Q000532:radiotherapy* / Q000556:secondary* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000532:radiotherapy* / Q000556:secondary* / Q000601:surgery; D002291:Carcinoma, Papillary / Q000532:radiotherapy* / Q000556:secondary* / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D011182:Postoperative Care; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000473:pathology* / Q000601:surgery; D013965:Thyroidectomy; D016896:Treatment Outcome
chemical_list: D007457:Iodine Radioisotopes