Objective: Our study aimed to analyse temporal trends in radioactive iodine (RAI) treatment for thyroid cancer over the past decade; to analyse key factors associated with clinical decisions in RAI dosing; and to confirm lower activities of RAI for low-risk patients were not associated with an increased risk of recurrence. Methods: Retrospective analysis of 1,323 patients who received RAI at a quaternary centre in Australia between 2008 and 2018 was performed. Prospectively collected data included age, gender, histology, and American Joint Committee on Cancer stage (7th ed). American Thyroid Association risk was calculated retrospectively. Results: The median activities of RAI administered to low-risk patients decreased from 3.85 GBq (104 mCi) in 2008–2016 to 2.0 GBq (54 mCi) in 2017–2018. The principal driver of this change was an increased use of 1 GBq (27 mCi) from 1.3% of prescriptions in 2008–2011 to 18.5% in 2017–2018. In patients assigned as low risk per ATA stratification, lower activities of 1 GBq or 2 GBq (27 mCi or 54 mCi) were not associated with an increased risk of recurrence. In patients assigned to intermediate- or high-risk categories who received RAI as adjuvant therapy, there was no difference in risk of recurrence between 4 GBq (108 mCi) and 6 GBq (162 mCi). Conclusions: Our data demonstrate an evolution of RAI activities consistent with translation of ATA guidelines into clinical practice. Use of lower RAI activities was not associated with an increase in recurrence in low-risk thyroid cancer patients. Our data also suggest lower RAI activities may be as efficacious for adjuvant therapy in intermediate- and high-risk patients.
Eur Thyroid J

中文翻译：

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分化型甲状腺癌中放射性碘给药实践的变化：单中心经验

目的：我们的研究旨在分析过去十年放射性碘（RAI）治疗甲状腺癌的时间趋势；分析与 RAI 剂量临床决策相关的关键因素；并确认低风险患者的 RAI 活动较低与复发风险增加无关。方法：对 2008 年至 2018 年间在澳大利亚四级中心接受 RAI 的 1,323 名患者进行回顾性分析。前瞻性收集的数据包括年龄、性别、组织学和美国癌症联合委员会分期（第 7 版）。回顾性计算美国甲状腺协会风险。结果：低风险患者的 RAI 活动中位数从 2008-2016 年的 3.85 GBq (104 mCi) 降至 2017-2018 年的 2.0 GBq (54 mCi)。这一变化的主要驱动力是 1 GBq (27 mCi) 的使用量从 2008-2011 年的 1.3% 增加到 2017-2018 年的 18.5%。在根据 ATA 分层分配为低风险的患者中，1 GBq 或 2 GBq（27 mCi 或 54 mCi）的较低活动与复发风险增加无关。在接受 RAI 作为辅助治疗的中危或高危患者中，4 GBq (108 mCi) 和 6 GBq (162 mCi) 之间的复发风险没有差异。结论：我们的数据表明 RAI 活动的演变与将 ATA 指南转化为临床实践一致。使用较低的 RAI 活动与低风险甲状腺癌患者的复发率增加无关。我们的数据还表明，较低的 RAI 活动对于中高危患者的辅助治疗可能同样有效。
欧洲甲状腺杂志