Is Radioactive Iodine (RAI) Therapy an effective adjuvant treatment for patients with Poorly differentiated thyroid carcinoma (PDTC)?
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BACKGROUND: Poorly differentiated thyroid carcinoma (PDTC) is a less common type. It is biologically more aggressive, with intermediate prognosis in comparision to differentiated thyroid carcinoma. Surgery remains the primary treatment, with the utility of radioactive iodine (RAI) ablation being unclear.
METHODS: In this retrospective study, we assessed the utility of RAI ablation after surgery in patients with PDTC (diagnosed as per Turin’s proposal). Patients treated between Jan 2012 to Dec 2017 were included. the demograpjic, clinical and treatment related details were recorded and their survival analyzed.
RESULTS: Thirty-nine patients out of the 50 PDTC patients treated in the mentioned time period fulfilled the eligibility criteria. It was common among women, with the median age being 55 yrs. All patients were reffered for RAI therapy after initial surgery. As per our institution protocol patients receive a low dose RAI scan with 100 micro Ci before ablation. All patients received RAI ablation subsequently with a median dose of 191 mCi (Range:40-261mCi). The post therapy scan showed minimal uptake in all.Eighteen patients received more than one ablation, mostly in the presence of distant metastasis. At a median follow up of 30 months, presence of diatant metastasis at initial diagnosis influenced the survival the most.
CONCLUSION: In oir patients all patients with PDTC treated with RAI showed uptake and responded to the treatment as documented by the post therapy scan. Hence PDTC patients should be considered for RAI ablation after surgery.
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- Jeff Blumberg