Thyroidectomy without I-131 noninferior in low-risk thyroid cancer (Radiation does not help)

Medical Xpress / New England Journal of Medicine ^ | Mar. 10, 2022 | Sophie Leboulleux et al / David S. Cooper,

[ConservativeMind]

For patients with low-risk thyroid cancer undergoing thyroidectomy, follow-up without use of radioiodine is noninferior to ablation with radioiodine, according to a study published in the March 10 issue of the New England Journal of Medicine.

Sophie Leboulleux, M.D., Ph.D., from the Gustave Roussy and Université Paris-Saclay in Villejuif, France, and colleagues conducted a prospective, phase 3 trial involving patients with low-risk differentiated thyroid cancer who were undergoing thyroidectomy. A total of 730 participants were randomly assigned to receive ablation with postoperative administration of radioiodine (1.1 GBq) after injections of recombinant human thyrotropin (radioiodine group) or to receive no postoperative radioiodine (no-radioiodine group); participants were evaluated three years after randomization.

The researchers found that the percentages of patients without a composite end point event (functional, structural, or biologic abnormalities) at three years were 95.6 and 95.9 percent in the no-radioiodine and radioiodine groups, respectively (difference, −0.3 percentage points), which met the noninferiority criteria. In eight patients, events consisted of structural or functional abnormalities, while 23 patients with 25 events had biologic abnormalities. Patients with a postoperative serum thyroglobulin level of more than 1 ng/mL during thyroid hormone treatment had more frequent events. Patients with or without an event had similar molecular alterations. There were no reports of treatment-related adverse events.

"Follow-up without the use of radioiodine after thyroidectomy was noninferior to the administration of 1.1 GBq of radioiodine after the administration of recombinant human thyrotropin," the authors write.

[ConservativeMind]

Radioactive iodine was not helpful in treating low-risk thyroid cancers, despite what the practice might be.

[ConservativeMind]

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[rlmorel]

It is interesting. I used to do this for a living.

[MayflowerMadam]

Our cat will have the I-131 treatment on Tuesday. She’ll be radioactive for a couple weeks. 😼

[Trillian]

I had that treatment after my surgery.

[Ruy Dias de Bivar]

I had an overactive thyroid back in 1978 and was given I-131 to kill it. I have been on synthroid or levithroid ever since.

No problems with it at all. About ten years after this I put a company geiger counter to my throat and got no reaction at all.

[Soul of the South]

Thyroid cancer in 2005. Complete thyroidectomy followed by I131. I take synthroid daily. Neck ultrasound every six months by my endocrinologist and synthroid dose adjusted if needed. No recurrence.

My biggest problem has been fighting insurance companies, and now Medicare to stay on branded synthroid instead of being forced to the generic.

[Sans-Culotte]

I had an overactive thyroid back in 1978 and was given I-131 to kill it. I have been on synthroid or levithroid ever since. No problems with it at all. About ten years after this I put a company geiger counter to my throat and got no reaction at all.

I had that done in 1991 for Graves Disease. Unfortunately, I developed Thyroid Eye Disease about 10 years later, necessitating 7 eye surgeries to correct it. My doctor only wants me to take Synthroid because of inconsistent dosage in the generic form.

[Sans-Culotte]

My biggest problem has been fighting insurance companies, and now Medicare to stay on branded synthroid instead of being forced to the generic.

I have been ordering Synthroid® for years from a Canadian pharmacy for that very reason. There is now a program in which you can order it direct from Synthroid called SYNTHROID DELIVERS. I take .175 daily and the 90-day refills from Synthroid cost me $75. Because I take a fairly high dose, that's a pretty good price IMO and better than my insurance could do. However, $25 per 30-day supply seems kind of high if you are taking a smaller dose.