High-Dose Radioiodine Therapy Did Not Result in Better Thyroglobulin Decline in Patients with Extra-Thyroid Tumor Extension of Papillary Thyroid Cancer

Abstract

Objective

In this study, the response to treatment in patients with extra-thyroid extension (ETE) of papillary thyroid cancer (PTC) was compared between different radioiodine treatment doses.

Methods and Materials

In this retrospective cross-sectional study, patients with pathology-proven ETE who were hospitalized for radioiodine therapy from December 2015 to May 2018 at a referral university hospital were identified. Demographic data, radioiodine doses, and off-levothyroxine thyroglobulin and antithyroglobulin levels, before and after treatment, were collected. Alterations in thyroglobulin levels before and after treatment were compared between patients receiving different doses of radioiodine.

Results

Sixty patients were analyzed (mean age: 44.1 ± 14.4 years; 61.7% females). On average, the thyroglobulin levels were 59.1 ± 92.0 and 45.7 ± 81.5 ng/mL at baseline and after treatment, respectively. The thyroglobulin levels decreased from 6.2 ± 6.3 to 1.7 ± 0.2 ng/mL (p = 0.510), 55.8 ± 101.3 to 11.5 ± 17.2 ng/mL (p = 0.07), and 62.8 ± 91 to 60.9 ± 93.1 ng/mL (p = 0.83) in the 100- to 149-, 150- to 199-, and 200- to 250-mCi iodine therapy groups, respectively. Treatment with doses of less than 200 mCi were significantly more effective in reducing posttreatment thyroglobulin levels compared with higher doses (p = 0.05). In the subgroup analysis, nonmetastatic cases treated with less than 200 mCi iodine had significantly greater thyroglobulin reduction compared with metastatic patients treated with ≥200 mCi iodine (p = 0.05). Macroscopic (vs. microscopic) invasion into adjacent tissues had no impact on thyroglobulin decrease.

Conclusion

The administration of higher radioiodine doses for the treatment of PTC patients with ETE does not yield additional therapeutic benefits in terms of posttreatment thyroglobulin reduction.

Keywords

extra-thyroid extension - PTC - radioiodine - therapeutic - thyroglobulin

Authors' Contributions

M.A., S.F., and Y.S. developed the concept and were responsible for scientific supervision. Data collection was done by M.G.H, M.B.K, and M.R.G. Data analysis was done by M.A., Y.S., and M.G.H. Scientific writing was done by M.A., M.G.H., and M.B.K. Manuscript editing was done by Y.S. and M.R.G.

The article has been read and approved by all the authors, the requirements for authorship mentioned in the journal information have been met, and each author believes that the article represents honest work.

Publication History

Article published online:
26 March 2025

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