RADIOIODINE THERAPY FOR DIFFERENTIATED THYROID CARCINOMA : INHS ASVINI EXPERIENCE

During last 17 years, 175 patients of carcinoma thyroid were treated in this centre. Hundred patients (57%) of papillary carcinoma formed majority. Fifty four patients (31%) were follicular carcinoma and 15 (8.5%) were mixed variety. Two (1.3%) were medullary carcinoma, 3 (1.7%) anaplastic type and 1 (0.5%) hurthle cell carcinoma. After surgery these patients were assessed for radio iodine uptake, residual thyroid tissue and distant metastasis which determined the dose of radioiodine for ablation. Fifty two per cent (91) patients presented as multi nodular goitre, 22.3 per cent (39) as solitary nodule, 13.7 per cent (24) had lymph node metastasis, 5.7 per cent (10) bone metastasis, 2.5 per cent (4) had lung metastasis and 3.8 per cent (7) presented as thyrotoxicosis. Average number of therapy for complete ablation in papillary carcinoma was 1.5, follicular 1.78 and mixed variety 1.5. 72.6 per cent cases (127) needed single dose for ablation, 14.9 per cent (26) needed 2 doses and 5.7 per cent (10) required 3 doses. Only 6.8 per cent (12) cases needed 4 to 8 doses. Average dose of I⁻¹³¹ administered for ablation was 157 mci in males and 124 mci in females of papillary carcinoma thyroid. Males in follicular variety required 204 mci and females needed only 120 mci. In mixed variety males required 177 mci and females required 62.5 mci for complete ablation. 144 patients (82.3%) were followed up to 5 years and remaining patients from 6 to 17 years. These patients are followed up once in a year or alternate years. Follow-up and medical record keeping for defence personnel is done with meticulous care, therefore followup results are very encouraging.KEYWORDS: Differentiated thyroid cancer, Radio iodine therapy, Thyroid ablation