Lithium as an Adjuvant in the Postoperative Ablation of Remnant Tissue in Low-Risk Thyroid Carcinoma

Lithium as an Adjuvant in the Postoperative Ablation of Remnant Tissue in Low-Risk Thyroid Carcinoma

Author Yamazaki, Claudia Akemi Autor UNIFESP Google Scholar
Padovani, Rosalia P. Autor UNIFESP Google Scholar
Mello Biscolla, Rosa Paula Autor UNIFESP Google Scholar
Ikejiri, Elza Setsuko Autor UNIFESP Google Scholar
Marchetti, Renata Rosa Autor UNIFESP Google Scholar
Castiglioni, Mario Luiz V. Autor UNIFESP Google Scholar
Matsumura, Luiza Kimiko Autor UNIFESP Google Scholar
Barros Maciel, Rui Monteiro de Autor UNIFESP Google Scholar
Furlanetto, Reinaldo Perrone Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Fleury Med & Hlth
Abstract Background: Thyroid remnant ablation (RA) with 30 mCi of radioactive iodine (I-131) in patients thyroidectomized for treatment of low-risk differentiated thyroid carcinoma (DTC) has a success rate of 64% to 84%. Lithium increases the residence time of I-131 in the thyroid tissue. the aim of this study was to determine if lithium treatment added to 30 mCi I-131 would enhance the success rate of this treatment compared with 30 mCi I-131 alone in patients who were thyroidectomized for treatment of low-risk DTC.Methods: This was a randomized study with endpoint at one year. Sixty one consecutive patients were enrolled and randomized into two groups: group A (n = 32) treated with 30 mCi I-131; group B (n = 29) treated with 30 mCi I-131 plus an oral dose of lithium 900 mg/day, for 7 days. All patients were evaluated by whole body scan (WBS) with I-123 and had serum TSH, thyroglobulin (Tg), and anti-Tg antibodies (TgAb) determined when they were hypothyroid on no thyroid hormone. Patients were reevaluated after one year with serum TSH, Tg, and TgAb determinations and WBS with I-123. the criteria for defining a successful outcome was a negative WBS and a serum Tg of < 1.Results: Group A was composed of 28 women and four men (ages 25-71 years) with 2 having follicular thyroid carcinoma (FTC), 22 having papillary thyroid carcinoma (PTC) of 1-4.5 cm, and 8 having micro PTCs (mPTC) of 0.3-0.8 cm. Group B was composed of 26 women and 3 men (ages 20-63 years) with 3 having FTC, 15 having PTC of 1.2-3.5 cm, and 11 having mPTC of 0.2-0.8 cm. All patients had a history of a WBS after their post-therapeutic I-131 dose that showed uptake in the cervical region. After one year, 22 patients from group A had a negative WBS (68.75%) and in group B, 27 patients had a negative WBS (93.1%). the successful rates for the follow-up WBS were significantly different (p = 0.017). There were 19 patients in Group A in whom the initial Tg was positive. of these, 14 had a negative follow-up Tg (73.7%). Group B had 9 patients with a positive initial Tg and all of them had a negative follow-up Tg (100%).Conclusion: the addition of lithium to treatment with 30 mCi I-131 in thyroidectomized patients with low-risk DTC improved the efficacy of thyroid RA and therefore might be a better alternative than using higher doses of I-131 for remnant ablation in these patients.
Language English
Date 2012-10-01
Published in Thyroid. New Rochelle: Mary Ann Liebert Inc, v. 22, n. 10, p. 1002-1006, 2012.
ISSN 1050-7256 (Sherpa/Romeo, impact factor)
Publisher Mary Ann Liebert Inc
Extent 1002-1006
Access rights Closed access
Type Article
Web of Science ID WOS:000309606200007

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