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KMID : 1148920140480040255
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Nuclear Medicine and Molecular Imaging
2014 Volume.48 No. 4 p.255 ~ p.261
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Stimulated Serum Thyroglobulin Level at the Time of First Dose of Radioactive Iodine Therapy Is the Most Predictive Factor for Therapeutic Failure in Patients With Papillary Thyroid Carcinoma
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Park Hee-Jeong
Jeong Geum-Cheol
Kwon Seong-Young
Min Jung-Joon
Bom Hee-Seung
Park Ki-Seong
Cho Sang-Geon
Kang Sae-Ryung
Kim Ja-Hae
Song Ho-Chun
Chong A-Ri
Yoo Su-Woong
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Abstract
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Purpose: To investigate the clinical importance of serum thyroglobulin (Tg) levels just before high-dose I-131 ablation therapy (preablation Tg) for predicting therapeutic failure in patients with papillary thyroid carcinoma (PTC).
Methods: Patients with PTC (n?=?132) undergoing total thyroidectomy followed by the first high-dose I-131 ablation therapy (HI-Rx) were included in this retrospective review. Just before HI-Rx, preablation Tg, anti-Tg antibody, and TSH were measured. The patients were followed up for a mean period of 7 months (range 6?23 months) by I-123 whole-body scans (f/u IWBS) and stimulated Tg (f/u Tg). Therapeutic failure was defined by positive f/u IWBS or f/u Tg >2 ng/ml. We classified patients into three groups according to the value of preablation Tg (group 1, <1 ng/ml; group 2, ≥1 and <10 ng/ml; group 3, ≥10 ng/ml) and compared clinical variables to therapeutic response.
Results: Therapeutic failure was noted in 39 patients (29.5 %). On univariate analysis, T stage, tumor size, and preablation Tg were the statistically significant factors that could predict therapeutic failure. After multivariate analysis, preablation Tg was the only independent predictor of therapeutic failure (P?
Conclusions: A high preablation Tg level is the most significant predictor of therapeutic failure at the time of first HI-Rx in patients with PTC.
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KEYWORD
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Papillary thyroid carcinoma, High-dose I-131 ablation therapy, Predictive factor, Thyroglobulin, Therapeutic failure
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