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Noninferior response in BRAFV600E mutant nonmetastatic papillary thyroid carcinoma to radioiodine therapy

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

As the most frequent and specific genetic alteration in papillary thyroid carcinoma (PTC), BRAFV600E has an intimate relationship with more invasive tumour and higher postoperative recurrence risk in PTC patients. We investigate the effect of radioactive iodine (RAI) therapy on the clinical outcome in PTC patients with the BRAFV600E mutation without distant metastases.

Methods

This retrospective study included PTC 228 patients without distant metastases who underwent total or near-total thyroidectomy and RAI treatment in our hospital from January 2011 to July 2014. The BRAFV600E status of the primary lesions was determined and the patients were divided into two groups according to the presence of the mutation. Serological and imaging data were collected at a median follow-up of 2.34 years after RAI administration. Suppressed and stimulated thyroglobulin (Tg), Tg antibody, diagnostic whole-body scintigraphy, and other imaging examinations were used to assess clinical outcome, which was defined as excellent response, indeterminate response, biochemical incomplete response and structural incomplete response.

Results

The BRAFV600E mutation was observed in 153 of the 228 patients (67.1 %). The clinicopathological features did not differ between the BRAFV600E mutatation and wild-type groups except age at diagnosis (P = 0.000), tumour size (P = 0.023) and TNM stage (P = 0.003). Older age and more advanced TNM stage were prevalent in the BRAFV600E mutatation group, whereas tumours were slightly larger in the BRAFV600E wild-type group. The response to RAI therapy was evaluated in both the entire series and the patients with a high recurrence risk, and no significant difference in response was found between the BRAFV600E mutatation and the wild-type groups (P = 0.881 and P = 0.851, respectively).

Conclusion

The clinical response to timely postsurgical RAI therapy is not inferior in BRAFV600E mutation PTC patients without distant metastases, which suggests that RAI therapy might improve the general clinical outcome in this patient group.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Peking Union Medical College Hospital, Beijing, 100730, China

    Jiao Li, Teng Zhao & Yansong Lin

  2. Department of Oncology, Peking University International Hospital, Beijing, 102206, China

    Jun Liang

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  1. Jiao Li
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  2. Jun Liang
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  3. Teng Zhao
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  4. Yansong Lin
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Corresponding author

Correspondence to Yansong Lin.

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Funding

This study was funded by National Natural Science Foundation of China (81571714).

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None.

Ethical approval

This article does not describe any studies with human participants performed by any of the authors. For this type of study formal approval is not required.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Jiao Li and Jun Liang contributed equally to this work as first authors.

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Li, J., Liang, J., Zhao, T. et al. Noninferior response in BRAFV600E mutant nonmetastatic papillary thyroid carcinoma to radioiodine therapy. Eur J Nucl Med Mol Imaging 43, 1034–1039 (2016). https://doi.org/10.1007/s00259-015-3305-1

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  • DOI: https://doi.org/10.1007/s00259-015-3305-1

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