title: Low- or high-dose radioiodine remnant ablation for differentiated thyroid carcinoma: a meta-analysis.
abstract: BACKGROUND
  There is uncertainty over the dose of (131)I required for thyroid remnant ablation. Most previous studies have been inadequately powered to establish the best fixed dose of (131)I for effective ablation.
  
  
  OBJECTIVE
  The aim of the study was to assess the effects of low- vs high-dose regimens of radioiodine in thyroid remnant ablation for patients with differentiated thyroid carcinoma.
  
  
  METHODS
  Sources included the Cochrane Library, MEDLINE, EMBASE, and SCOPUS (all until September 2012).
  
  
  METHODS
  Randomized controlled trials that assess the efficacy of low- or high-dose of radioiodine ablation of thyroid remnants were collected.
  
  
  METHODS
  Two authors performed the data extraction independently.
  
  
  RESULTS
  Nine randomized controlled trials involving 2569 patients were included. The 1100-MBq vs the 3700-MBq radioiodine showed no statistically significant difference in successful thyroid remnant ablation (risk ratio [RR], 0.91 [0.79 to 1.04]; P = .15), both the 1100 vs the 1850 MBq (RR, 0.95 [0.83 to 1.10]; P = .52) and the 1850 vs the 3700 MBq (RR, 1.00 [0.85 to 1.17]; P = .98) also showed no significant differences (95% confidence intervals were calculated for each estimate). Also, no significant differences existed in quality-of-life scores on the SF-36 between different (131)I-dose groups both on the day of ablation (RR, 0.15 [-0.65 to 0.96], P = .71; I(2) = 29%, P = .24) and 3 months after ablation (RR, -1.1 [-2.37 to 0.17], P = .09; I(2) = 22%, P = .26). A low dose of 1100 MBq radioiodine showed significant benefits in reducing adverse effects (total RR, 0.65 [0.55 to 0.77], P < .1; I(2) = 31%, P =.14) and shorter hospital isolation (RR, 0.4 [0.32 to 0.50]; P < .05).
  
  
  CONCLUSIONS
  The low dose of 1100 MBq radioiodine activity is sufficient for thyroid remnant ablation as compared to 3700 MBq radioiodine activity with similar quality of life, less common adverse effects, and a shorter hospital stay.
authors: Department of Nuclear Medicine, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
authors: Weiwei
authors: W
authors: Cheng
authors: Chao
authors: C
authors: Ma
authors: Hongliang
authors: H
authors: Fu
authors: Jianing
authors: J
authors: Li
authors: Suyun
authors: S
authors: Chen
authors: Shuqi
authors: S
authors: Wu
authors: Hui
authors: H
authors: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D002277:Carcinoma / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D002454:Cell Differentiation; D004307:Dose-Response Relationship, Radiation; D006801:Humans; D007457:Iodine Radioisotopes / Q000008:administration & dosage* / Q000009:adverse effects; D018365:Neoplasm, Residual; D011788:Quality of Life; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D013964:Thyroid Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D013965:Thyroidectomy; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007457:Iodine Radioisotopes