울산의대/ 서민정, 박설훈*
Abstract
PURPOSE:
The aim of this study was to evaluate the effectiveness of low-dose radioactive iodine (RAI) ablation in patients with small papillary thyroid cancer (PTC) exhibiting microscopic extrathyroidal extension (mETE) and central lymph node (CLN) metastasis.
METHODS:
Among patients who underwent RAI ablation between March 2007 and February 2014, those who had small PTCs (≤2 cm), as well as mETE and CLN metastasis (T3 N1a M0), were enrolled. Response to ablation and long-term outcomes were assessed and compared according to the administered RAI dose. Factors associated with unsuccessful ablation were also determined.
RESULTS:
A total of 180 patients were included in the study. Eighty-eight patients had been treated with 1110 MBq (low-dose group) and 92 with 2960 MBq (high-dose group) of RAI. There were no significant differences in the responses to ablation (P = 0.810) and long-term outcomes (P = 0.663) between both groups. Among all patients enrolled, 13 did not achieve successful ablation at long-term follow-up. Logistic regression found that a high ratio of metastatic nodes was a significant factor for predicting unsuccessful ablation.
CONCLUSIONS:
Low-dose RAI ablation did not produce significantly different responses or long-term outcomes in patients with small PTCs exhibiting mETE and CLN metastasis. These findings suggest that low-dose ablation may be sufficient in this specific group of intermediate-risk patients, although careful selection is required for patients with a high ratio of metastatic nodes.
Author information
Seo M1, Kim YS, Lee JC, Han MW, Kim ES, Kim KB, Park SH.
1From the Departments of *Nuclear Medicine, †Surgery, ‡Otorhinolaryngology, §Internal Medicine, and ∥Pathology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
편집위원
개정된 ATA guideline에서 저용량치료와 active surveillance가 자주 언급되는 가운데 저용량 치료에 대한 연구는 임상에 검토후 바로 적용할 수 있는 좋은 자료라 생각됩니다.
2017-12-12 15:39:40