title: Radioactive iodine in the treatment of medullary thyroid carcinoma: a controlled multicenter study.
abstract: OBJECTIVE
  Radioactive iodine (RAI) therapy in medullary thyroid carcinoma (MTC) is applied in some centers, based on the assumption that cross-irradiation from thyroid follicular cells may be beneficial. However, no systematic studies on the effect of RAI treatment in MTC have been performed. The aim of this study was to analyze the effect of RAI treatment on survival in MTC patients.
  
  
  METHODS
  Retrospective multicenter study in eight University Medical Centers in The Netherlands.
  
  
  METHODS
  Two hundred and ninety three MTC patients without distant metastases who had undergone a total thyroidectomy were included between 1980 and 2007. Patients were stratified by clinical appearance, hereditary stage, screening status, and localization. All patients underwent regular surgical treatment with additional RAI treatment in 61 patients. Main outcome measures were disease-free survival (DFS) and disease-specific survival (DSS). Cure was defined as biochemical and radiological absence of disease.
  
  
  RESULTS
  In multivariate analysis, stratification according to clinical appearance (P=0.72), hereditary stage (P=0.96), localization (P=0.69), and screening status (P=0.31) revealed no significant effects of RAI treatment on DFS. Multivariate analysis showed no significant difference in DSS for the two groups stratified according to clinical appearance (P=0.14). Owing to limited number of events, multivariate analysis was not possible for DSS in the other groups of stratification.
  
  
  CONCLUSIONS
  Based on the results of the present analysis, we conclude that RAI has no place in the treatment of MTC.
authors: Department of Internal Medicine, Albert Schweitzer Hospital, Dordrecht, The Netherlands. jaa.meijer@asz.nl
authors: J A A
authors: JA
authors: Meijer
authors: L E H
authors: LE
authors: Bakker
authors: G D
authors: GD
authors: Valk
authors: W W
authors: WW
authors: de Herder
authors: J H W
authors: JH
authors: de Wilt
authors: R T
authors: RT
authors: Netea-Maier
authors: N
authors: N
authors: Schaper
authors: E
authors: E
authors: Fliers
authors: P
authors: P
authors: Lips
authors: J T
authors: JT
authors: Plukker
authors: T P
authors: TP
authors: Links
authors: J A
authors: JA
authors: Smit
mesh_terms: D000368:Aged; D018276:Carcinoma, Medullary / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011379:Prognosis; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000532:radiotherapy*; D016896:Treatment Outcome
chemical_list: D007457:Iodine Radioisotopes