[Role of iodine-131 in the management of differentiated thyroid cancers (vesicular origin)].
Radioodine-131 has an important place in the management of well-differentiated thyroid cancer. Patient preparation for radioiodine-131 administration must be rigorous and is based on the stimulation of endogenous TSH production, which requires a hypothyroid state after withdrawal of suppressive T4-therapy. The introduction of recombinant human TSH would simplify the protocol of preparation and improve the quality of life of patients. The diagnosis place of radioiodine-131 knew significant changes following the introduction of the serum thyroglobulin measurement. This tumour marker has a central role in the strategy of follow-up and tends to be the principal element of indication for a diagnosis exploration with radioidine-131. The systematic ablation of thyroid remnants remains controversial particularly in patients with good prognosis factors; the efficacy of low activities is also still debatable. The optimal follow-up strategy and the indication of remnant ablation must take in account the prognosis factors of survival and recurrence. Radioiodine-131 therapy permits frequently the cure of distant metastases, particularly in infraradiological pulmonary forms. This fact outlines the importance of an early detection of tumour recurrence based on the conjunction of radioiodine-131 and thyroglobulin. Side effects of radioiodine-131 therapy are generally limited if the precautionary measures are well applied; leukaemia constitutes the main risk but this complication is very uncommon and occurs after a high cumulative activity.
Boughattas
Sami
S
Service de Médecine Nucléaire, Hôpital Sahloul-4054-Sousse-Tunisie.
Hassine
Habib
H
Chatti
Kaouther
K
Letaief
Bechir
B
Jomaa
Rached
R
Essabbah
Habib
H
D003937:Diagnosis, Differential; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging; D011379:Prognosis; D011877:Radionuclide Imaging; D013954:Thyroglobulin / Q000032:analysis*; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000532:radiotherapy*; D013972:Thyrotropin / Q000032:analysis
D007457:Iodine Radioisotopes; D013972:Thyrotropin; D013954:Thyroglobulin
Apport de l'iode 131 dans la prise en charge des cancers differencies de la thyroïde (d'origine vesiculaire).