Optimal Cumulative I-131 Activity in Metastatic Differentiated Thyroid Cancer: Balancing Efficacy and Adverse Events
Authors' conclusion
The study suggests that a maximum CA of up to 1000 mCi strikes a favorable balance between keeping AEs low and benefiting a subset of patients with extensive metastases showing intense I-131 concentration.
Study context
- Population
- Adults with metastatic DTC treated with I-131 and followed ≥2 years, 1967–2019; mean age 48 years (range 19–81)median follow-up 122 months
- Participants
- 671 adults
- Exposure
- Cumulative I-131 activity ≤600 mCi vs >600-1000 mCi vs >1000 mCi
- Group An = 269reference
- Group Bn = 212
- Group Cn = 190
- Outcome
- Long-term AEs and survival outcomes
Methodological detailslong-term cohort
- Long-term cohort
Main finding
As reported in the abstract
AEs by I-131 cumulative activity · median follow-up 122 months
P < 0.001
- Total adverse events (AEs) observed
- 40/671 (6%) in 38 patients
Observational data: associations, not effects.
Further findings
Ten-year survival · 10 years
Safety
Events
| Outcome | Group A | Group B | Group C |
|---|---|---|---|
| Second primary malignancy | 3 | 1 | 1 |
- Second primary malignancy — Patients with second primary malignancy
- 5
Bone marrow suppression, decreased pulmonary function and xerostomia
- Cumulative activity (CA) >1000 mCi associated with significant increase
- P < 0.001
Original publication
Optimal Cumulative I-131 Activity in Metastatic Differentiated Thyroid Cancer: Balancing Efficacy and Adverse Events. J Clin Endocrinol Metab. Published 12 January 2024. doi:10.
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