Hong-Jun Song1, Zhong-Ling Qiu1, Chen-Tian Shen1, Wei-Jun Wei1, Quan-Yong Luo2. 1. Department of Nuclear MedicineShanghai Sixth People's Hospital, Shanghai Jiao Tong University, 600 Yishan Road, Shanghai 200233, People's Republic of China. 2. Department of Nuclear MedicineShanghai Sixth People's Hospital, Shanghai Jiao Tong University, 600 Yishan Road, Shanghai 200233, People's Republic of China lqyn@sh163.net.
Abstract
CONTEXT: Data from a large cohort of patients with pulmonary metastases from differentiated thyroid cancer (DTC) were retrospectively analyzed. OBJECTIVE: To assess the effect of radioiodine therapy and investigate the prognostic factors of survival for patients with pulmonary metastasis secondary to DTC. METHODS: A total of 372 patients with pulmonary metastasis from DTC treated with (131)I entered the study. According to the results of (131)I whole-body scan (WBS), pulmonary metastases were classified as (131)I-avid and non-(131)I-avid. For patients with (131)I-avid lung metastases, treatment response was measured by three parameters: serum thyroglobulin (Tg) levels, chest computed tomography (CT) and post-therapeutic (131)I-WBS. Overall survival was calculated by the Kaplan-Meier method. Factors predictive of the outcome were determined by multivariate analyses. RESULTS: Among patients demonstrating (131)I-avid pulmonary metastases (256/372, 68.8%), 156 cases (156/256, 60.9%) showed a significant decrease in serum Tg levels after (131)I therapy and 138 cases (138/229, 60.3%) showed a reduction in pulmonary metastases on follow-up CT. A complete cure, however, was only achieved in 62 cases (62/256, 24.2%). Multivariate analysis showed that only age, the presence of multiple distant metastases and pulmonary metastatic node size were significant independent variables between the groups of (131)I-avid and non-(131)I-avid. CONCLUSION: This study indicated that, most (131)I-avid pulmonary metastases from DTC can obtain partial or complete remission after (131)I therapy. Younger patients (<40 years old) with only pulmonary metastases and small ('fine miliaric' or micronodular) metastases appear to have relative favorite outcomes. Patients who do not respond to (131)I treatment have a worse prognosis.
CONTEXT: Data from a large cohort of patients with pulmonary metastases from differentiated thyroid cancer (DTC) were retrospectively analyzed. OBJECTIVE: To assess the effect of radioiodine therapy and investigate the prognostic factors of survival for patients with pulmonary metastasis secondary to DTC. METHODS: A total of 372 patients with pulmonary metastasis from DTC treated with (131)I entered the study. According to the results of (131)I whole-body scan (WBS), pulmonary metastases were classified as (131)I-avid and non-(131)I-avid. For patients with (131)I-avid lung metastases, treatment response was measured by three parameters: serum thyroglobulin (Tg) levels, chest computed tomography (CT) and post-therapeutic (131)I-WBS. Overall survival was calculated by the Kaplan-Meier method. Factors predictive of the outcome were determined by multivariate analyses. RESULTS: Among patients demonstrating (131)I-avid pulmonary metastases (256/372, 68.8%), 156 cases (156/256, 60.9%) showed a significant decrease in serum Tg levels after (131)I therapy and 138 cases (138/229, 60.3%) showed a reduction in pulmonary metastases on follow-up CT. A complete cure, however, was only achieved in 62 cases (62/256, 24.2%). Multivariate analysis showed that only age, the presence of multiple distant metastases and pulmonary metastatic node size were significant independent variables between the groups of (131)I-avid and non-(131)I-avid. CONCLUSION: This study indicated that, most (131)I-avid pulmonary metastases from DTC can obtain partial or complete remission after (131)I therapy. Younger patients (<40 years old) with only pulmonary metastases and small ('fine miliaric' or micronodular) metastases appear to have relative favorite outcomes. Patients who do not respond to (131)I treatment have a worse prognosis.
Authors: Myat Han Soe; Janet M Chiang; Robert R Flavell; Elham Khanafshar; Laura Mendoza; Hyunseok Kang; Chienying Liu Journal: J Clin Endocrinol Metab Date: 2022-07-14 Impact factor: 6.134
Authors: Thomas Crezee; Marika H Tesselaar; James Nagarajah; Willem E Corver; Johannes Morreau; Catrin Pritchard; Shioko Kimura; Josephina G Kuiper; Ilse van Engen-van Grunsven; Jan W A Smit; Romana T Netea-Maier; Theo S Plantinga Journal: Cell Oncol (Dordr) Date: 2021-02-03 Impact factor: 6.730
Authors: Thomas Crezee; Marika H Tesselaar; Martin Jaeger; Katrin Rabold; Willem E Corver; Hans Morreau; Adriana C H Van Engen-Van Grunsven; Jan W A Smit; Romana T Netea-Maier; Theo S Plantinga Journal: Oncol Lett Date: 2021-06-06 Impact factor: 2.967