THYROID REMNANT ABLATION - QUESTIONABLE PURSUIT OF AN ILL-DEFINED GOAL

  • 1 January 1983
    • journal article
    • research article
    • Vol. 24  (8) , 659-665
Abstract
Ablative therapy with 131I in 30-mCi doses, directed to postsurgical remnants in patients with differentiated thyroid cancer, reduced visible 131I uptake to 0 or .apprx. 0 in 81% of patients, but did not protect against tumor recurrence in 6 of 69 patients who were followed for 2-5 yr. Recurrences developed within 5-37 mo. Effectiveness of 30-mCi doses of 131I in producing ablation did not correlate with 131I uptake by the thyroid remnant, surgeon''s estimate of remnant size, or delivered dose to the remnant in rads, calculated using reasonable assumptions. The difficulty of dosimetric measurements and calculations is emphasized. The value of postsurgical ablative therapy in diminishing morbidity and mortality in patients with differentiated thyroid cancer has not yet been firmly established, and until this is done a conservative approach to thyroid ablation, with 30-mCi treatment doses of 131I and 1-mCi neck-scanning doses to check on effectiveness of therapy, is advocated.