title: Spanish consensus for the management of patients with advanced radioactive iodine refractory differentiated thyroid cancer.
abstract: BACKGROUND
  Approximately one third of the patients with differentiated thyroid cancer (DTC) who develop structurally-evident metastatic disease are refractory to radioactive iodine (RAI). Most deaths from thyroid cancer occur in these patients. The main objective of this consensus is to address the most controversial aspects of management of these patients.
  
  
  METHODS
  On behalf of the Spanish Society of Endocrinology & Nutrition (SEEN) and the Spanish Group for Orphan and Infrequent Tumors (GETHI), the Spanish Task Force for Thyroid Cancer, consisting of endocrinologists and oncologists, reviewed the relevant literature and prepared a series of clinically relevant questions related to management of advanced RAI-refractory DTC.
  
  
  RESULTS
  Ten clinically relevant questions were identified by the task force. In answering to these 10 questions, the task force included recommendations regarding the best definition of refractoriness; the best therapeutic options including watchful waiting, local therapies, and systemic therapy (e.g. kinase inhibitors), when sodium iodide symporter (NIS) restoration may be expected; and how recent advances in molecular biology have increased our understanding of the disease.
  
  
  CONCLUSIONS
  In response to our appointment as a task force by the SEEN and GHETI, we developed a consensus to help in clinical management of patients with advanced RAI-refractory DTC. We think that this consensus will provide helpful and current recommendations that will help patients with this disorder to get optimal medical care.
authors.affiliation: Department of Endocrinology and Nutrition, Hospital Universitario de Móstoles, Madrid, Spain. Electronic address: griesco@iib.uam.es.
authors.forename: Garcilaso
authors.initials: G
authors.lastname: Riesco-Eizaguirre
authors.affiliation: Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, Pamplona, Navarra, Spain.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Galofré
authors.affiliation: Medical Oncology Department, Ramon y Cajal University Hospital, Madrid, Spain.
authors.forename: Enrique
authors.initials: E
authors.lastname: Grande
authors.affiliation: Department of Endocrinology and Nutrition, Vall d'Hebron University Hospital, Barcelona, Spain.
authors.forename: Carles
authors.initials: C
authors.lastname: Zafón Llopis
authors.affiliation: Medical Oncology Department, Santa Creu i Sant Pau University Hospital, Barcelona, Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: Ramón y Cajal Asensio
authors.affiliation: Department of Endocrinology and Nutrition, Vírgen del Rocío University Hospital, Sevilla, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Navarro González
authors.affiliation: Medical Oncology Department, Central de Asturias University Hospital, Oviedo, Asturias, Spain.
authors.forename: Paula
authors.initials: P
authors.lastname: Jiménez-Fonseca
authors.affiliation: Department of Endocrinology and Nutrition, Hospital Universitario de Cruces, Baracaldo, Vizcaya, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Santamaría Sandi
authors.affiliation: CIBERDEM Service of Endocrinology and Nutrition, Hospital Universitario de Bellvitge, Barcelona, Spain.
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Gómez Sáez
authors.affiliation: Medical Oncology Department, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Jaume
authors.initials: J
authors.lastname: Capdevila
mesh_terms: D006801:Humans; D007455:Iodine / Q000627:therapeutic use*; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D013964:Thyroid Neoplasms / Q000188:drug therapy*
chemical_list: D007457:Iodine Radioisotopes; D007455:Iodine
keywords: Clinical management; Consenso español; Cáncer diferenciado de tiroides; Differentiated thyroid cancer; Manejo clínico; Radioactive iodine refractory; Refractario al yodo radioactivo; Spanish consensus