Short-term hazards of low-dose radioiodine ablation therapy in postsurgical thyroid cancer patients.
During the last two decades, there has been a trend to use low-dose I-131 ablation therapy in patients with thyroid carcinoma without metastases. However, information regarding the incidence of acute adverse reactions in patients after low-dose radioiodine therapy has not been reported. In this study, the acute radiation effects after low-dose radioiodine ablation therapy in postsurgical differentiated thyroid cancer patients was evaluated. Fifty-six patients with differentiated thyroid cancer were prospectively evaluated. None of these patients had evidence of a distant metastasis. All patients received 40 mCi (1480 MBq) I-131 MIBG orally and were evaluated for symptoms and signs by a physician on the second and seventh days after therapy. Xerostomia and nausea were the most common complaints with the same incidence rate of 5.35%. Gastralgia occurred at a frequency of 3.57%. Pain in the thyroid bed, tenderness over a parotid gland, submandibular glands, change in taste, and vomiting all were found at a frequency of 1.78%. Maximum reactions generally occurred 24-48 hours after therapy. All the symptoms except for xerostomia resolved completely in most patients within a week. In comparison with high-dose ablation therapy published in the literature, the incidence of radiation reactions in low-dose radioiodine therapy was much lower. It was concluded that in patients without lymph node or distant metastases, low-dose I-131 MIBG therapy may be recommended to avoid the high incidence of local complications after high-dose treatment.
Lin
W Y
WY
Department of Nuclear Medicine, Taichung Veterans General Hospital, Taiwan.
Shen
Y Y
YY
Wang
S J
SJ
D019797:3-Iodobenzylguanidine; D018263:Adenocarcinoma, Follicular / Q000000981:diagnostic imaging / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002291:Carcinoma, Papillary / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000008:administration & dosage* / Q000009:adverse effects*; D007462:Iodobenzenes / Q000008:administration & dosage* / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000209:etiology; D010146:Pain / Q000209:etiology; D011446:Prospective Studies; D011877:Radionuclide Imaging; D018714:Radiotherapy, Adjuvant; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D014987:Xerostomia / Q000209:etiology
D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D019797:3-Iodobenzylguanidine