The nonimpact of thyroid stunning: remnant ablation rates in 131I-scanned and nonscanned individuals.
Thyroid stunning has been reported as the temporary impairment of thyroid tissue after a 111-MBq or greater diagnostic 131I dose that decreases the final absorbed dose in ablative therapy. Concerns regarding the reality of stunning have arisen in part due to a flawed study design in prior reports. To assess whether a stunning effect has any impact on therapeutic outcomes, we compared initial treatment ablation rates in patients who received 111- to 185-MBq 131I diagnostic scans (n = 37) before ablative doses of 3700-7400 MBq with ablation rates in patients who did not receive any 131I before the initial treatment dose (n = 63). Ablation rates were 64.9% for scanned patients and 66.7% for nonscanned patients, a nonsignificant difference. Nonscanned patients with metastatic lesions (n = 23) were ablated at a higher rate (78.3%) than scanned patients (n = 9) (66.7%), but the difference was not significant (P = 0.50). It is possible that the reported stunning phenomenon, specifically its impact in temporarily impairing tissue, has been overemphasized.
Morris
L F
LF
Department of Medicine, Cedars-Sinai Medical Center-University of California School of Medicine, Los Angeles, California 90048, USA.
Waxman
A D
AD
Braunstein
G D
GD
D018263:Adenocarcinoma, Follicular / Q000000981:diagnostic imaging / Q000532:radiotherapy; D000328:Adult; D002291:Carcinoma, Papillary / Q000000981:diagnostic imaging / Q000532:radiotherapy; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008297:Male; D011877:Radionuclide Imaging; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D013961:Thyroid Gland / Q000528:radiation effects*; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging* / Q000532:radiotherapy*
D007457:Iodine Radioisotopes