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Maximal safe dose of I-131 after failure of standard fixed dose therapy in patients with differentiated thyroid carcinoma

Cited 32 time in Web of Science Cited 33 time in Scopus
Authors
Lee, Jong Jin; Chung, June-Key; Kim, Sung Eun; Kang, Won Jun; Park, Do Joon; Lee, Dong Soo; Cho, Bo Youn; Lee, Myung Chul
Issue Date
2008-11-29
Publisher
Springer Verlag
Citation
Ann Nucl Med. 2008;22(9):727-34
Keywords
AdultAgedDose FractionationDose-Response Relationship, RadiationFemaleHumansIodine Radioisotopes/*administration & dosage/*toxicityLeukemia/*chemically induced/*prevention & controlMale*Maximum Tolerated DoseMiddle AgedRadiopharmaceuticals/administration & dosage/toxicityRadiotherapy DosageThyroid Neoplasms/*radiotherapyTreatment FailureTreatment OutcomeYoung Adult
Abstract
OBJECTIVE: The maximal safe dose (MSD) on the basis of bone marrow irradiation levels allows the delivery of a large amount of I-131 to thyroid cancer tissue. The efficacy of MSD therapy in differentiated metastatic thyroid cancers that persisted after conventional fixed dose therapy is investigated. METHODS: Forty-seven differentiated thyroid carcinoma patients with non-responsive residual disease despite repetitive fixed dose I-131 therapy were enrolled in this study. Their postoperative pathologies were 43 papillary carcinomas and 4 follicular carcinomas. The MSD was calculated with the Memorial Sloan-Kettering Cancer Center protocol using serial blood samples. The MSDs were administered at intervals of 6 months. Treatment responses were evaluated using I-131 whole-body scans and serum thyroglobulin measurements. RESULTS: The mean calculated MSD was 12.5 +/- 2.1 GBq (339.6 +/- 57.5 mCi). Of the 46 patients, 7 (14.9%) showed complete remission, 15 (31.9%) partial remission, 19 (40.4%) stable disease, and 6 (12.8%) disease progression. Of the patients who showed complete or partial remission, 15 (65%) showed response after the first MSD session and 6 (26%) showed response after the second session. Twenty-nine patients (62%) experienced transient cytopenia after therapy, but three did not recover to the baseline level. CONCLUSIONS: The maximal safe dose provides an effective means of treatment in patients who failed to respond adequately to conventional fixed dose therapy. I-131 MSD therapy can be considered in patients who fail fixed dose therapy.
ISSN
0914-7187 (Print)
Language
English
URI
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19039550

http://www.springerlink.com/content/u1w26q5217512224/fulltext.pdf

http://hdl.handle.net/10371/67803
DOI
https://doi.org/10.1007/s12149-007-0179-8
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Appears in Collections:
College of Medicine/School of Medicine (의과대학/대학원)Nuclear Medicine (핵의학전공)Journal Papers (저널논문_핵의학전공)
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