Abstract
To evaluate the role of low-dose radioiodine in the treatment of non-metastatic high-risk differentiated thyroid cancer (DTC) patients with macroscopic extra-thyroidal extension (MAEE). Totally 103 DTC patients with total/near-total thyroidectomy and selective lymph node resection, and with MAEE, any N stage,preablative stimulated thyroglobulin (ps-Tg) ≤ 5 ng/ml when thyroglobulin antibodies (TgAb) ≤ 46 U/ml and no evidence of distant metastasis were retrospectively analyzed in this study. Fifty-two received low dose RAI (1110 MBq) and 51 received high dose (≥ 3700 MBq). The successful ablation rate and disease-free survival rate were compared between these two groups. The successful ablative rate was 86.5% (45/52) in low-dose group and 86.3% (44/51) in high-dose group (P=0.9688), and the disease-free survival was 97.4% (38/39) in low-dose group and 97.5% (39/40) in high-dose group. The ablation success and medium-term clinical outcome with low-dose RAI is proved to be non-inferior to high dose in non-metastatic patients with MAEE when ps-Tg level is less than 5 ng/ml.
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