Potential of the drug-regulation iodide uptake in patients for prevention of radioiodine-refractory papillary thyroid cancer

Objective

To evaluate the efficacy and feasibility of retinoic acid derivatives and lithium salts for radioiodine-refractory prevention in patients with differentiated thyroid cancer during multistage radioiodine therapy.

Materials and methods

The retrospective analysis was performed using the diagnostic and treatment results of 40 patients with differentiated thyroid cancer that underwent ¹³¹I therapy, which on the basis of posttherapy whole-body scan had direct indications for subsequent course of radioiodine therapy. The patients were divided into two groups:

1. the control group (20 patients), which conducted a second course of radioiodine therapy on the standard template and without special training$
2. the main group (20 patients), who were administered Sedalia (900 mg per day for 8 days, p.o.) and isotretinoin (1.2 mg/kg body weight for 60 days, p.o.) to prevention of the ¹³¹I resistance.

To evaluate the effectiveness of a repeated course of radioiodine therapy following parameters were used: the thyroglobulin (Tg) and antibodies to thyroglobulin (Tg-Ab) level in the serum, the posttherapy whole body scan in combination with SPECT-CT.

Results

We have found, that radioactive iodine treatment was effective in 75% of the main group and 90% of patients in the control group. The remission was observed in 10% and 40% in the main and control group, respectively. The partial regression was considered as Tg and TG-Ab reduction, and was observed more in the study group. The resistance to ¹³¹I therapy was found in 20% and 10% in the main and control group, respectively, which was based on the fact of permanent Tg/Tg-Ab serum level and absence of the pathological foci iodine uptake on the whole-body scans. The disease progress was found in one patient in the main group.

Conclusion

The use of retinoic acid derivatives and lithium salts, in an effort to prevent the resistance to ¹³¹I-theraphy pretend to be unjustified, because it does not lead to significant improvement in long-term results and reduce the number of ¹³¹I-resistance.

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