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Clinical and Translational Imaging

, Volume 7, Issue 6, pp 427–435 | Cite as

Multimodal therapy of advanced differentiated thyroid cancer, with emphasis on the role of radioiodine

  • Alice Lorenzoni
  • Antonella Capozza
  • Alfredo Campennì
  • Luca GiovanellaEmail author
  • Ettore Seregni
Expert Review
Part of the following topical collections:
  1. Endocrine

Abstract

Introduction

Differentiated thyroid cancer (DTC) accounts for 95% of all thyroid cancers and is generally an indolent tumor, tending to present with limited loco-regional disease with an excellent long-term survival after treatment. However, 5–10% present with locally advanced disease and aero-digestive tract invasion or distant metastases that are the main cause of thyroid cancer-related deaths.

Methods

The present review aims to underline the complex management of advanced DTC including treatment of gross extra-thyroidal extension, recurrent loco-regional, or distant metastatic disease.

Results

Radioiodine therapy is an effective treatment of advanced and/or metastatic DTC which contributes significantly to patients’ life expectancy. Multimodal approach based on surgical resection in combination with radioiodine therapy, interventional imaging treatment, and TSH suppression can significantly improve outcomes for this patients’ population.

Keywords

Thyroid cancer Radioiodine Advanced disease Distant metastasis Advanced thyroid cancer Radioiodine therapy Local treatments Thyrosin kinase inhibitors 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Enewold L, Zhu K, Ron E et al (2009) Rising thyroid cancer incidence in the United States by demographic and tumor characteristics, 1980–2005. Cancer Epidemiol Biomark Prev 18:784–791CrossRefGoogle Scholar
  2. 2.
    Chen AY, Jemal A, Ward EM (2009) Increasing incidence of differentiated thyroid cancer in the United States, 1988–2005. Cancer 115:3801–3807CrossRefGoogle Scholar
  3. 3.
    Ruegemer JJ, Hay ID, Bergstralh EJ et al (1988) Distant metastases in differentiated thyroid carcinoma: a multivariate analysis of prognostic variables. J Clin Endocrinol Metab 67(3):501–508CrossRefGoogle Scholar
  4. 4.
    Haugen BR, Kane MA (2010) Approach to the thyroid cancer patient with extracervical metastases. J Clin Endocrinol Metab 95:987–993CrossRefGoogle Scholar
  5. 5.
    Amin MB, Greene FL, Edge SB et al (2017) The eighth edition AJCC cancer staging manual: continuing to build a bridge from a population-based to a more “personalized” approach to cancer staging. CA Cancer J Clin 67(2):93–99CrossRefGoogle Scholar
  6. 6.
    Segal K, Shpitzer T, Hazan A et al (2006) Invasive well-differentiated thyroid carcinoma: effect of treatment modalities on outcome. Otolaryngol Head Neck Surg 134(5):819–822CrossRefGoogle Scholar
  7. 7.
    Kiess AP, Agrawal N, Brierley JD et al (2016) External-beam radiotherapy for differentiated thyroid cancer locoregional control: a statement of the American head and neck society. Head Neck 38:493–498CrossRefGoogle Scholar
  8. 8.
    Perros P, Boelaert K, Colley S et al (2014) British thyroid association. Guidelines for the management of thyroid cancer. Clin Endocrinol (Oxf) 81(Suppl 1):1–122CrossRefGoogle Scholar
  9. 9.
    Romesser PB, Sherman EJ, Shaha AR et al (2014) External beam radiotherapy with or without concurrent chemotherapy in advanced or recurrent nonanaplastic non-medullary thyroid cancer. J Surg Oncol 110:375–382CrossRefGoogle Scholar
  10. 10.
    Elshafie O, Hussein S, Jeans WD et al (2000) Massive rise in thyroglobulin with adult respiratory distress syndrome after embolisation of thyroid cancer metastasis. Br J Radiol 73(869):547–549CrossRefGoogle Scholar
  11. 11.
    Baek JH, Kim YS, Sung JY et al (2011) Locoregional control of metastatic well-differentiated thyroid cancer by ultrasound-guided radiofrequency ablation. AJR Am J Roentgenol 197(2):W331–W336CrossRefGoogle Scholar
  12. 12.
    Monchik JM, Donatini G, Iannuccilli J et al (2006) Radiofrequency ablation and percutaneous ethanol injection treatment for recurrent local and distant well-differentiated thyroid carcinoma. Ann Surg 244:296–304CrossRefGoogle Scholar
  13. 13.
    Fontenot TE, Deniwar A, Bhatia P et al (2015) Percutaneous ethanol injection vs reoperation for locally recurrent papillary thyroid cancer: a systematic review and pooled analysis. JAMA Otolaryngol Head Neck Surg 141(6):512–518CrossRefGoogle Scholar
  14. 14.
    Muresan MM, Olivier P, Leclère J et al (2008) Bone metastases from differentiated thyroid carcinoma. Endocr Relat Cancer 15(1):37–49CrossRefGoogle Scholar
  15. 15.
    Durante C, Haddy N, Baudin E et al (2006) Long-term outcome of 444 patients with distant metastases from papillary and follicular thyroid carcinoma: benefits and limits of radioiodine therapy. J Clin Endocrinol Metab 91(8):2892–2899CrossRefGoogle Scholar
  16. 16.
    Bernier MO, Leenhardt L, Hoang C et al (2001) Survival and therapeutic modalities in patients with bone metastases of differentiated thyroid carcinomas. J Clin Endocrinol Metab 86(4):1568–1573CrossRefGoogle Scholar
  17. 17.
    Quan GM, Pointillart V, Palussière J et al (2012) Multidisciplinary treatment and survival of patients with vertebral metastases from thyroid carcinoma. Thyroid 22(2):125–130CrossRefGoogle Scholar
  18. 18.
    Lencioni R, Crocetti L, Cioni R et al (2008) Response to radiofrequency ablation of pulmonary tumours: a prospective, intention-to-treat, multicentre clinical trial (the RAPTURE study). Lancet Oncol 9(7):621–628CrossRefGoogle Scholar
  19. 19.
    de Baere T, Palussiere J, Auperin A et al (2006) Midterm local efficacy and survival after radiofrequency ablation of lung tumors with minimum follow-up of 1 year: prospective evaluation. Radiology 240(2):587–596CrossRefGoogle Scholar
  20. 20.
    Lo SS, Fakiris AJ, Chang EL, Mayr NA, Wang JZ, Papiez L et al (2010) Stereotactic body radiation therapy: a novel treatment modality. Nat Rev Clin Oncol 7(1):44–54CrossRefGoogle Scholar
  21. 21.
    Henriques de Figueiredo B, Godbert Y et al (2014) Brain metastases from thyroid carcinoma: a retrospective study of 21 patients. Thyroid 24(2):270–276CrossRefGoogle Scholar
  22. 22.
    McWilliams RR, Giannini C, Hay ID et al (2003) Management of brain metastases from thyroid carcinoma: a study of 16 pathologically confirmed cases over 25 years. Cancer 98(2):356–362CrossRefGoogle Scholar
  23. 23.
    Wertenbroek MW, Links TP, Prins TR, Plukker JT, van der Jagt EJ, de Jong KP (2008) Radiofrequency ablation of hepatic metastases from thyroid carcinoma. Thyroid 18(10):1105–1110CrossRefGoogle Scholar
  24. 24.
    Hertz S, Roberts A (1942) Application of radioactive iodine in Graves disease. J Clin Invest 21:624Google Scholar
  25. 25.
    Seidlin SM, Marinelli LD, Oshry E (1946) Radioactive iodine therapy: effect on functioning metastases of adenocarcinoma of the thyroid. JAMA 132:838–847CrossRefGoogle Scholar
  26. 26.
    Verburg FA, de Keizer B, Lips CJM, Zelissen PMJ, de Klerk JMH (2005) Prognostic significance of successful ablation with radioiodine of differentiated thyroid cancer patients. Eur J Endocrinol 152:33–37CrossRefGoogle Scholar
  27. 27.
    Schlumberger M, Challeton C, De Vathaire F, Travagli JP, Gardet P, Lumbroso JD, Francese C, Fontaine F, Ricard M, Parmentier C (1996) Radioactive iodine treatment and external radiotherapy for lung and bone metastases from thyroid carcinoma. J Nucl Med 37(4):598–605PubMedGoogle Scholar
  28. 28.
    Edmonds CJ, Hayes S, Kermode JC, Thompson BD (1977) Measurement of serum TSH and thyroid hormones in the management of treatment of thyroid carcinoma with radioiodine. Br J Radiol 50(599):799–807CrossRefGoogle Scholar
  29. 29.
    Vrachimis A, Riemann B, Mader U et al (2016) Endogenous TSH levels at the time of 131I ablation do not influence ablation success, recurrence-free survival or differentiated thyroid cancer-related mortality. Eur J Nucl Med Mol Imaging 43:224–231CrossRefGoogle Scholar
  30. 30.
    Tala H, Robbins R, Fagin JA, Larson SM, Tuttle RM (2011) Five-year survival is similar in thyroid cancer patients with distant metastases prepared for radioactive iodine therapy with either thyroid hormone withdrawal or recombinant human TSH. J Clin Endorcrinol Metab 96:2105–2111CrossRefGoogle Scholar
  31. 31.
    Jarzab B, Handkiewicz-Junak D, Roskosz J, Puch Z, Wygoda Z, Kukulska A, Jurecka-Lubieniecka B, Hasse-Lazar K, Turska M, Zajusz A (2003) Recombinant human TSH-aided radioiodine treatment of advanced differentiated thyroid carcinoma: a single-centre study of 54 patients. Eur J Nucl Med Mol Imaging 30(8):1077–1086CrossRefGoogle Scholar
  32. 32.
    Sawka AM, Ibrahim-Zada I, Galacgac P, Tsang RW, Brierley JD, Ezzat S, Goldstein DP (2010) Dietary iodine restriction in preparation for radioactive iodine treatment or scanning in well-differentiated thyroid cancer: a systematic review. Thyroid 20(10):1129–1138CrossRefGoogle Scholar
  33. 33.
    Pluijmen MJ, Eustatia-Rutten C, Goslings BM, Stokkel MP, Arias AM, Diamant M, Romijn JA, Smit JW (2003) Effects of low-iodide diet on postsurgical radioiodide ablation therapy in patients with differentiated thyroid carcinoma. Clin Endocrinol (Oxf) 58(4):428–435CrossRefGoogle Scholar
  34. 34.
    Tala Jury HP, Castagna MG, Fioravanti C, Cipri C, Brianzoni E, Pacini F (2010) Lack of association between urinary iodine excretion and successful thyroid ablation in thyroid cancer patients. J Clin Endocrinol Metab 95(1):230–237CrossRefGoogle Scholar
  35. 35.
    Kulkarni K, Van Nostrand D, Atkins F et al (2006) The relative frequency in which empiric dosages of radioiodine would potentially overtreat or undertreat patients who have metastatic well-differentiated thyroid cancer. Thyroid 16:1019–1023CrossRefGoogle Scholar
  36. 36.
    Tuttle RM, Leboeuf R, Robbins RJ et al (2006) Empiric radioactive iodine dosing regimens frequently exceed maximum tolerated activity levels in elderly patients with thyroid cancer. J Nucl Med 47:1587–1591PubMedGoogle Scholar
  37. 37.
    Thies ED, Tanase K, Maeder U et al (2014) The number of 131I therapy courses needed to achieve complete remission is an indicator of prognosis in patients with differentiated thyroid carcinoma. Eur J Nucl Med Mol Imaging 41(12):2281–2290CrossRefGoogle Scholar
  38. 38.
    Samuel AM, Rajashekharrao B, Shah DH (1998) Pulmonary metastases in children and adolescents with well-differentiated thyroid cancer. J Nucl Med 39:1531–1536PubMedGoogle Scholar
  39. 39.
    Diessl S, Holzberger B, Mäder U, Grelle I, Smit JW, Buck AK, Reiners C, Verburg FA (2012) Impact of moderate vs stringent TSH suppression on survival in advanced differentiated thyroid carcinoma. Clin Endocrinol (Oxf) 76(4):586–592CrossRefGoogle Scholar

Copyright information

© Italian Association of Nuclear Medicine and Molecular Imaging 2019

Authors and Affiliations

  1. 1.Nuclear Medicine, Fondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
  2. 2.Nuclear Medicine, University Hospital and University of MessinaMessinaItaly
  3. 3.Nuclear Medicine and Competence Centre for Thyroid DiseasesEnte Ospedaliero CantonaleBellinzonaSwitzerland
  4. 4.Nuclear Medicine, University Hospital and University of ZurichZurichSwitzerland

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