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Effectiveness of retinoic acid treatment for redifferentiation of thyroid cancer in relation to recovery of radioiodine uptake

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Abstract

Background: Retinoic acid (RA) treatment has been used for redifferentiation of metastatic thyroid neoplasia that have lost radioiodine (131I) uptake with heterogeneous results. Aim: Retrospective analysis of the recovery rate of 1311 uptake after RA treatment in patients from 11 Spanish hospitals. Methods: Twenty-seven patients (14 men, 13 women) with papillary [21], follicular [4], and oncocytic [2] thyroid cancer initially treated with total thyroidectomy plus 131I, and with 131I negative metastatic disease, were given 13-cis RA (0.66–1.5 mg/kg for 5–12 weeks) followed by a therapeutic 131I dose (3700–7400 MBq); 3 months later thyroglobulin levels and computed tomography imaging were performed. Results: In 9 out 27 cases (33%) (8 papillary, 1 follicular) optimal positive 131I scan was observed after RA treatment; in the remaining 18, 10 had a suboptimal uptake (7 papillary, 2 follicular, 1 oncocytic) and in the rest there was no 131I uptake recovery (6 papillary, 1 follicular, 1 oncocytic). In 17 positive responses to RA (either optimal or suboptimal) in which image follow-up was available, decrease or stabilization of metastatic growth was observed in 7, while tumor mass increased at short term in the remaining 10. No major side effects were detected. Conclusion: Quite a high rate of 131I uptake recovery after RA treatment may be obtained in advanced differentiated thyroid cancer, but the potential modification of the natural course of the disease is uncertain. A better biological characterization of these tumors allowing the identification of potential responders to RA may improve the outcome of RA coadjuvant therapy.

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Authors and Affiliations

  1. Endocrinology Service, Hospital Clinic, Villaroel 170, 08036, Barcelona, Spain

    C. A. Fernández, M. Puig-Domingo & I. Halperin MD, PhD

  2. Nuclear Medicine Service, Barcelona Clinical Hospital, Spain

    F. Lomeña

  3. Nuclear Medicine Service, Sant Pau Hospital, Barcelona

    M. Estorch & V. Camacho Martí

  4. Nuclear Medicine Service, Gregorio Marañón Hospital, Spain

    A. L. Bittini

  5. Endocrinology Service, Princess Hospital, Madrid

    M. Marazuela

  6. Endocrinology Service, Cruces Hospital, Baracaldo

    J. Santamaría

  7. Nuclear Medicine Service, Virgen de Macarena Hospital, Sevilla

    J. Castro

  8. Endocrinology Service, Leganés University Hospital, Leganés

    P. Martínez de Icaya

  9. Endocrinology Service, Móstoles Hospital, Móstoles

    I. Moraga

  10. Endocrinology Service, Virgen Macarena Hospital, Sevilla

    T. Martín

  11. Endocrinology Service, Joan XXIII University Hospital, Tarragona

    A. Megía

  12. Endocrinology Service, Vic General Hospital, Vic

    M. Porta

  13. Endocrinology Service, Arnau de Vilanova Hospital, Lleida, Spain

    D. Mauricio

Authors
  1. C. A. Fernández
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  2. M. Puig-Domingo
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  3. F. Lomeña
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  4. M. Estorch
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  6. A. L. Bittini
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  7. M. Marazuela
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  9. J. Castro
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  10. P. Martínez de Icaya
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  11. I. Moraga
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  12. T. Martín
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  13. A. Megía
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  14. M. Porta
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  15. D. Mauricio
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  16. I. Halperin MD, PhD
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Correspondence to I. Halperin MD, PhD.

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Fernández, C.A., Puig-Domingo, M., Lomeña, F. et al. Effectiveness of retinoic acid treatment for redifferentiation of thyroid cancer in relation to recovery of radioiodine uptake. J Endocrinol Invest 32, 228–233 (2009). https://doi.org/10.1007/BF03346457

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  • DOI: https://doi.org/10.1007/BF03346457

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