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Endocrine

, Volume 62, Issue 3, pp 655–662 | Cite as

30mCi radioactive iodine achieving comparative excellent response in intermediate/high-risk nonmetastatic papillary thyroid cancer: a propensity score matching study

  • Yingqiang Zhang
  • Chen Wang
  • Xin Zhang
  • Hui Li
  • Xin Li
  • Yansong LinEmail author
Original Article
  • 139 Downloads

Abstract

Objective

To determine the efficacy of low-dose radioactive iodine (RAI) therapy (30 mCi, 1110 MBq) in Chinese patients with intermediate- to high-risk papillary thyroid cancer (PTC) without distant metastasis.

Design and methods

This large retrospective study included Chinese patients with PTC that tested negative for thyroglobulin antibodies. Patients were categorized into low-dose (30 mCi, 1110 MBq) and high-dose (>100 mCi, 3700 MBq) RAI groups. Ablation rate and long-term response were compared between groups using propensity score matching (PSM) to minimize bias and confounding.

Results

In total, we included 446 patients. No significant difference in ablation success rate was found between groups (P = 0.305) before or after PSM (N = 162; P = 0.200). Excellent response (ER) rate was not significant between groups before (P= 0.917) or after PSM (P= 0.798). Efficacy of low-dose RAI was similar to that of high-dose RAI in N0- (P= 1.000), N1a- (P= 0.981), and N1b-stage (P= 0.903) patients. Low- and high-dose RAI groups achieved similar ER rates in pre-ablative stimulated thyroglobulin level (≤1 ng/mL, P= 1.000; 1 < ps-Tg ≤ 5 ng/mL, P= 0.444; 5 < ps-Tg ≤ 10 ng/mL, P= 0.665; >10 ng/mL, P= 1.000) and BRAFV600E-positive (P= 0.324) subgroups.

Conclusions

Efficacy of low-dose RAI therapy was similar to that of high-dose for ablation and achieving ER in Chinese nonmetastatic intermediate- to high-risk PTC patients. High-dose RAI could not rectify ablation failure or non-ER rates in PTC patients with BRAFV600E, lymph node metastases, or unfavorable thyroglobulin levels.

Keywords

Papillary thyroid cancer Radioactive iodine therapy TNM staging Response 

Notes

Funding

This work was supported by the National Natural Science Foundation of China (Grant nos. 81571714 and 81771875) and the CSCO-Hengrui Research Foundation (No. Y-HR2016-032). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The present study was approved by the institutional review board of Peking Union Medical College Hospital (Beijing, China) Ethics Committee. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

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

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Yingqiang Zhang
    • 1
    • 2
  • Chen Wang
    • 1
    • 2
    • 3
  • Xin Zhang
    • 1
    • 2
  • Hui Li
    • 1
    • 2
  • Xin Li
    • 4
  • Yansong Lin
    • 1
    • 2
    Email author
  1. 1.Department of Nuclear MedicinePeking Union Medical College HospitalBeijingChina
  2. 2.Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear MedicineBeijingChina
  3. 3.Centre Médical Universitaire (CMU), Université de GenèveGenevaSwitzerland
  4. 4.Department of Nuclear MedicineZhejiang Cancer HospitalHangzhouChina

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