Radyoaktif İyot Tedavisi Sonrası Diferansiye Tiroid Kanserlerinin Takibi-The Follow-up of Differentiated Thyroid Cancers After Radioactive Iodine Treatment

Yıl 2015, Cilt: 6 Sayı: 21, 30 - 37, 01.04.2015

Ebuzer Kalender Füsun Aydoğan Cem Oruç

Öz

Özet: Diferansiye tiroid kanserleri (DTK) çok iyi prognoza sahip en sık görülen endokrin malignitelerdir. Tiroidektomi sonrası seçilen hastalara uygulanan radyoaktif iyot tedavisi (RİT) oldukça etkin bir tedavi yöntemidir. Bu hastalarda tedavi sonrası takipler, nüks oranlarının yüksek olması ve bazı olgularda uzak metastaz gelişmesi nedeniyle büyük önem arzetmektedir. Bu derlemede RİT sonrası DTK’lı hastaların takibinde kullanılan yöntemler anlatılmaktadır.

Anahtar Kelimeler: Diferansiye tiroid kanseri, Radyoaktif iyot tedavisi, Takip

Abstarct: Differentiated thyroid cancerc (DTC) which have very good prognosis are the most common endocrine malignancies. Radioactive iodine treatment (RIT) applied to selected patients after thyroidectomy is a highly effective treatment method. Post-treatment follow-up of these patients exhibits a great importance because of the higher relapse rates and development of distant metastases in some cases. In this review, the methods used in the follow-up DTC patients after RIT are reported.

Key Words:

Giriş: Differentiated thyroid cancer, Radioactive iodine treatment, Follow-up.

Anahtar Kelimeler

Diferansiye tiroid kanseri, Radyoaktif iyot tedavisi, Takip

Kaynakça

• Referanslar:
• Golden SH, Robinson KA, Saldanha I, Anton B, Ladenson PW. Clinical review: prevalence and incidence of endocrine and metabolic disorders in the United States: a comprehensive review. J Clin Endocrinol Metab. 2009;94:1853–78.
• Hodgson NC, Button J, Solorzano CC. Thyroid cancer: is the incidence still increasing? Ann Surg Oncol. 2004;11:1093–7.
• Sawka AM, Thephamongkhol K, Brouwers M, Thabane L, Browman G, Gerstein HC. Clinical review 170: a systematic review and metaanalysis of the effectiveness of radioactive iodine remnant ablation for well-differentiated thyroid cancer. J Clin Endocrinol Metab. 2004;89:3668–76.
• Pacini F, Schlumberger M, Harmer C, Berg GG, Cohen O, Duntas L, et al. Post-surgical use of radioiodine (131I) in patients with papillary and follicular thyroid cancer and the issue of remnant ablation: a consensus report. Eur J Endocrinol. 2005;153:651–9.
• Mazzaferri EL, Kloos RT. Clinical review 128: current approaches to primary therapy for papillary and follicular thyroid cancer. J Clin Endocrinol Metab. 2001;86:1447–63.
• Eustatia-Rutten CF, Corssmit EP, Biermasz NR, Pereira AM, Romijn JA, Smit JW. Survival and death causes in differentiated thyroid carcinoma. J Clin Endocrinol Metab. 2006;91:313–9.
• Schlumberger MJ, Filetti S, Hay ID. Non toxic goiter and thyroid neoplasia. In: Larsen RP, Kronenberg HM, Melmed S, Polonsky KS, eds. Williams’ textbook of endocrinology. 10th ed. Philadelphia: WB Saunders Company. 2003;457–90.
• Shoup M, Stojadinovic A, Nissan A, Ghossein RA, Freedman S, Brennan MF, et al. Prognostic indicators of outcomes in patients with distant metastases from differentiated thyroid carcinoma. J Am Coll Surg. 2003;197:191-7.
• Cooper DS, Doherty GM, Haugen BR, Hauger BR, Kloos RT, Lee SL, et al. 2009 Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 2009;19:1167–214.
• Schlumberger MJ. Papillary and follicular thyroid carcinoma. N Engl J Med. 1998;338:297–306.
• Mazzaferri EL, Jhiang SM. Long-term impact of initial surgical and medical therapy on papillary and follicular thyroid cancer. Am J Med. 1994;97:418–28.
• Pacini F, Agate L, Elisei R, Capezzone M, Ceccarelli C, Lippi F, et al. Outcome of differentiated thyroid cancer with detectable serum Tg and negative diagnostic (131)I whole body scan: comparison of patients treated with high (131)I activities versus untreated patients. J Clin Endocrinol Metab. 2001; 86:4092-7.
• Kalender E, Elboga U, Celen YZ, Demi HD, Sahin E, Yilmaz M. Is it necessary to perform control diagnostic 131I whole body scanafter remmant ablation in differentiated thyroid carcinoma patients who have stimulated Tg levels under 2 ng/ml? Intern Med Inside. 2013; 1:10. http://dx.doi.org/10.7243/2052-6954-1-10.
• Cailleux AF, Baudin E, Travagli JP, Ricard M and Schlumberger M: Is diagnostic iodine-131 scanning useful after total thyroid ablation for differentiated thyroid cancer? J Clin Endocrinol Metab 2000;85:175-8.
• Taylor H, Hyer S, Vini L, Pratt B, Cook G and Harmer C: Diagnostic 131-I whole body scanning after thyroidectomy and ablation for differentiated thyroid cancer. Eur J Endocrinol 2004; 150:649-53.
• Pacini F, Capezzone M, Elisei R, Ceccarelli C, Taddei D, Pinchera A. Diagnostic 131-iodine whole-body scan may be avoided in thyroid cancer patients who have undetectable stimulated serum Tg levels after initial treatment. J Clin Endocrinol Metab 2002;87:1499-501
• Mazzaferri EL, Robbins RJ, Spencer CA, Braverman LE, Pacini F, Wartofsky L et al. A consensus report of the role of serum thyroglobulin as a monitoring method for low-risk patients with papillary thyroid carcinoma. J Clin Endocrinol Metab 2003;88:1433-41
• Schlumberger M, Berg G, Cohen O, Duntas L, Jamar F, Jarzab B, et al. Follow-up of low-risk patients with differentiated thyroid carcinoma: a European perspective. Eur J Endocrinol 2004;150:105-12
• Baloch Z, Carayon P, Conte-Devolx B, Demers LM, Feldt-Rasmussen U, Henry JF, et al. Laboratory medicine practice guidelines. Laboratory support for the diagnosis and monitoring of thyroid disease. Thyroid 2003;13:3-126.
• Ozata M, Suzuki S, Miyamoto T, Liu RT, Fierro-Renoy F, Degroot LJ. Serum thyroglobulin in the follow-up of patients with treated differentiated thyroid cancer. J Clin Endocrinol Metab 1994;79:98-105.
• Kloos RT, Mazzaferri EL. A single recombinant human thyrotropin-stimulated serum thyroglobulin measurement predicts differentiated thyroid carcinoma metastases three to five years later. J Clin Endocrinol Metab 2005;90:5047-57.
• Han JM, Kim WB, Yim JH, Kim WG, Kim TY, Ryu JS, ET AL. Long-term clinical outcome of differentiated thyroid cancer patients with undetectable stimulated thyroglobulin level one year after initial treatment. Thyroid 2012;22:784-90.
• Klubo-Gwiezdzinska J, Burman KD, Van ND, Wartofsky L. Does an undetectable rhTSH-stimulated Tg level 12 months after initial treatment of thyroid cancer indicate remission? Clin Endocrinol (Oxf) 2011;74:111-7.
• Haugen BR, Ridgway EC, McLaughlin BA, McDermott MT. Clinical comparison of whole-body radioiodine scan and serum thyroglobulin after stimulation with recombinant human thyrotropin. Thyroid 2002;12:37-43.
• Lima N, Cavaliere H, Tomimori E, Knobel M, Medeiros-Neto G. Prognostic value of serial serum thyroglobulin determinations after total thyroidectomy for differentiated thyroid cancer. J Endocrinol Invest 2002;25:110-5.
• Wartofsky L. Management of low-risk well-differentiated thyroid cancer based only on thyroglobulin measurement after recombinant human thyrotropin. Thyroid 2002;12:583-90.
• Rosario PW, Borges MA, Fagundes TA, Franco AC, Purisch S. Is stimulation of thyroglobulin (Tg) useful in low-risk patients with thyroid carcinoma and undetectable Tg on thyroxin and negative neck ultrasound? Clin Endocrinol (Oxf) 2005;62:121-5.
• Smallridge RC, Meek SE, Morgan MA, Gates GS, Fox TP, Grebe S, Fatourechi V: Monitoring thyroglobulin in a sensitive immunoassay has comparable sensitivity to recombinant human tsh-stimulated thyroglobulin in follow-up of thyroid cancer patients. J Clin Endocrinol Metab 2007;92:82-7.
• Iervasi A, Iervasi G, Ferdeghini M, Solimeo C, Bottoni A, Rossi L, et al. Clinical relevance of highly sensitive Tg assay in monitoring patients treated for differentiated thyroid cancer. Clin Endocrinol (Oxf) 2007;67:434-41.
• Kalender E, Elboga U, Celen YZ, Demir HD, Sahin E, Karacavus S, et al. Stimulated tg level measurements may be avoided in differentiated thyroid carcinoma patients who have undetectable basal tg levels. Intern Med Inside 2013, 1:5.http://dx.doi.org/10.7243/2052-6954-1-5.
• Castagna MG, Tala Jury HP, Cipri C, Belardini V, Fioravanti C, Pasqui L, et al. The use of ultrasensitive thyroglobulin assays reduces but does not abolish the need for TSH stimulation in patients with differentiated thyroid carcinoma. J Endocrinol Invest 2011;34:219-23.
• Kim ES, Lim DJ, Baek KH, Lee JM, Kim MK, Kwon HS, et al. Thyroglobulin antibody is associated with increased cancer risk in thyroid nodules. Thyroid 2010;20:885–9.
• Grebe SK. Thyroglobulin autoantibodies, thyroid nodules, and new insights into some old questions. Thyroid 2010;20:841–2.
• Kim WG, Yoon JH, Kim WB, Kim TY, Kim EY, Kim JM, et al. Change of serum antithyroglobulin antibody levels is useful for prediction of clinical recurrence in thyroglobulin-negative patients with differentiated thyroid carcinoma. J Clin Endocrinol Metab 2008;93:4683-9.
• Kalender E, Elboğa U, Demir H.D, Başıbüyük M, Çelen YZ, Yılmaz M. Diferansiye tiroid karsinomlu hastalarda Anti-Tg antikor düzeylerinin önemi: Olgu sunumu. Bozok Tıp Derg 2014;4:67-70.
• Preissner CM, O’Kane DJ, Singh RJ, Morris JC, Grebe SK. Phantoms in the assay tube: heterophile antibody interferences in serum thyroglobulin assays. J Clin Endocrinol Metab 2003;88:3069-74.
• Pacini F, Molinaro E, Castagna MG, Agate L, Elisei R, Ceccarelli C, et al. Recombinant human thyrotropin-stimulated serum thyroglobulin combined with neck ultrasonography has the highest sensitivity in monitoring differentiated thyroid carcinoma. J Clin Endocrinol Metab 2003;88:3668-73.
• Mazzaferri EL. Empirically treating high serum tg levels. J Nucl Med 2005;46(7):1079-88.
• Torlontano M, Attard M, Crocetti U, Tumino S, Bruno R, Costante G, et al. Follow- up of low risk patients with papillary thyroid cancer: role of neck ultrasonography in detecting lymph node metastases. J Clin Endocrinol Metab. 2004;89:3402–7.
• Antonelli A, Miccoli P, Fallahi P, Grosso M, Nesti C, Spinelli C, Ferrannini E. Role of neck ultrasonography in the follow-up of children operated on for thyroid papillary cancer. Thyroid. 2003;13:479–84.
• Torres MR, Nobrega Neto SH, Rosas RJ, Martins AL, Ramos AL, da Cruz TR. Thyroglobulin in the washout fluid of lymph-node biopsy: what is its role in the follow-up of differentiated thyroid carcinoma? Thyroid 2014;24:7-18
• Torlontano M, Crocetti U, D'Aloiso L, Bonfitto N, Di Giorgio A, Modoni S, et al. Serum thyroglobulin and 131I whole body scan after recombinant human TSH stimulation in the follow- up of low-risk patients with differentiated thyroid cancer. Eur J Endocrinol 2003;148:19 –24.
• Lind P, Kresnik E, Kumnig G, Gallowitsch HJ, Igerc I, Matschnig S, Gomez I. 18F-FDG-PET in the follow-up of thyroid cancer. Acta Med Austriaca 2003;30:17–21.
• Helal BO, Merlet P, Toubert ME, Franc B, Scvarthz C, et al. Clinical impact of 18F-FDG PET in thyroid carcinoma patients with elevated thyroglobulin levels and negative 131I scanning results after therapy. J Nucl Med 2001;42:1464 –9.
• Schluter B, Bohuslavizki KH, Beyer W, Plotkin M, Buchert R, Clausen M. Impact of FDG PET on patients with differentiated thyroid cancer who present with elevated thyroglobulin and negative131I scan. J Nucl Med 2001;42:71–6.
• Leboulleux S, Schroeder PR, Busaidy NL, Auperin A, Corone C, Jacene HA, et al. Assessment of the incremental value of recombinant thyrotropin stimulation before 2-[18F]-Fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography imaging to localize residual differentiated thyroid cancer. J Clin Endocrinol Metab 2009;94:1310-6
• Deandreis D, Al GA, Leboulleux S, Lacroix L, Garsi JP, Talbot M, et al. Do histological, immunohistochemical, and metabolic (radioiodine and fluorodeoxyglucose uptakes) patterns of metastatic thyroid cancer correlate with patient outcome? Endocr Relat Cancer 2011;18:159-69.
• Ahn JE, Lee JH, Yi JS, Shong YK, Hong SJ, Lee DH, et al. Diagnostic accuracy of CT and ultrasonography for evaluating metastatic cervical lymph nodes in patients with thyroid cancer. World J Surg 2008;32:1552-8.
• Choi JS, Kim J, Kwak JY, Kim MJ, Chang HS, Kim EK. Preoperative staging of papillary thyroid carcinoma: comparison of ultrasound imaging and CT. AJR Am J Roentgenol 2009;193:871-8.
• Wang JC, Takashima S, Takayama F, Kawakami S, Saito A, Matsushita T, et al. Tracheal invasion by thyroid carcinoma: prediction using MR imaging. AJR Am J Roentgenol 2001;177:929-36.
• Wang J, Takashima S, Matsushita T, Takayama F, Kobayashi T, Kadoya M. Esophageal invasion by thyroid carcinomas: prediction using magnetic resonance imaging. J Comput Assist Tomogr 2003;27:18-25.