Effects Of Radioactive Iodine Research Articles

Effectiveness of radioactive iodine (RAI) therapy and its associations with different factors in people presenting with hyperthyroidism; an analysis from Karachi-Pakistan

Effectiveness of radioactive iodine (RAI) therapy and its associations with different factors in people presenting with hyperthyroidism; an analysis from Karachi-Pakistan

Radioactive iodine treatment for Graves' hyperthyroidism: incidence of Graves orbitopathy.

There are limited recent data on the effect of radioactive iodine (RAI) for Graves' disease on Graves' orbitopathy (GO) development or reactivation. This audit investigates the GO incidence in patients with Graves' disease after RAI treatment, and explores risk factors present, and steroid prophylaxis use. A retrospective audit of Graves' disease patients treated with RAI over a 5-year period. Data collected: smoking status, thyroid-stimulating hormone receptor antibody (TRAb) status, GO history, Graves' disease duration, eye features pre- and post-treatment, prophylactic corticosteroids, RAI dose given, post-RAI thyroid status, duration until hypothyroid. One hundred one patients were included, with a median Graves' disease duration 36 months. 34/101 (33.7%) were active/ex-smokers, 86/101 (85.1%) were TRAb-positive, 11/101 (10.9%) had a GO history; 32 (31.7%) had eye features present. Median RAI dose given was 596MBq. 8/101 (7.9%) patients received prophylactic corticosteroid; 89/101 (88.1%) achieved hypothyroid state in the year after RAI. GO developed in 5/101 (5.0%), of which 4/5 (80%) were de novo in high-risk individuals who did not receive steroids. One was a GO reactivation despite steroids. Two required intravenous steroids with/without orbital radiotherapy, one completed oral steroid taper; the remainder were treated conservatively. Our cohort had a lower GO incidence in patients with Graves' disease receiving RAI, with majority arising de novo . It is essential that all patients are assessed for Graves orbitopathy risk factors and counselled adequately prior to RAI. The decision to initiate steroids should be undertaken in a multi-disciplinary setting involving endocrinologists and ophthalmologists.

The effectiveness of radioactive iodine vs thyroidectomy for paediatric grave's disease: a systematic review and meta-analysis

The effectiveness of radioactive iodine vs thyroidectomy for paediatric grave's disease: a systematic review and meta-analysis

The effect of radioactive iodine (RAI) on disease-specific survival in differentiated thyroid cancer (DTC): A study of 96,557 patients.

e18095 Background: The use of RAI in the treatment of DTC of various stages and risk levels is widespread. However, its efficacy continues to be a subject of debate, particularly with regard to low-risk patients. Some studies have found significant differences in RAI's ability to decrease recurrence and distant metastasis, while others have not. Thus, we conducted this study to evaluate the effect of RAI on disease-specific survival (DSS) in patients with DTC without distant metastasis. Methods: Data were obtained from the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) database between the years 2000 and 2018. Patients who have distant metastatic, tumor size ≥200 mm, receiving chemotherapy or any type of radiation other than RAI were excluded. Only patients with total thyroidectomy as surgical procedure were included. These patients were classified into three groups based on their histology: classical papillary thyroid carcinoma (C-PTC), follicular type variant carcinoma (FV-PTC), and follicular thyroid cancer (FTC). T-tests and chi-square tests were employed to compare variables, while the Cox proportional hazards model was utilized to assess the effect of RAI on DSS, presenting adjusted hazard ratios and confidence intervals. Results: The study population consisted of 96,557 patients, with 59,460 classified as having C-PTC, 31,583 as FV-PTC, and 5,489 as FTC. Most patients were female (78.6%), and the mean age was 45.8 years. 80.5% of the patients were white. The mean tumor size was 19.4 mm, with FTC tumors having a larger mean size of 34.8 mm. About a third of cases had an extrathyroidal extension. FV-PTC had the most favorable survival outcome with a 5-year DSS of 97.9%, followed by C-PTC (97.1%) and then FTC (96.9%). RAI was administered to 61.2% of FTC cases, 53.2% of C-PTC cases, and 52.1% of FV-PTC cases. In both FV-PTC and C-PTC, patients who received RAI had significantly better long-term survival than those who underwent surgery alone. The multivariable analysis confirmed that RAI had a more favorable prognosis in FV-PTC (HR = 0.68, 95%CI: 0.61 to 0.77, p<0.001) and C-PTC (HR = 0.60, 95%CI: 0.54 to 0.67, p<0.001), but did not result in improved DSS in FTC (HR = 0.87, 95%CI: 0.70 to 1.09, p = 0.226). There was a survival difference between the three histological subtypes in the overall cohort (p<0.001), even after matching baseline characteristics (p = 0.019). Conclusions: Our results showed that RAI administration was statistically associated with improved long-term DSS outcomes in FV-PTC and C-PTC histological subtypes, but not in FTC. However, a careful interpretation of these results is needed as the survival benefit was less than 3% in all cohorts, it might be clinically insignificant. This study was the first to examine all histological types of DTC using a large sample size. There is a need for a randomized trial to confirm the efficacy of RAI in FTC treatment.

Effects of radioactive iodine on clonal hematopoiesis in patients with thyroid cancer: A prospective study.

Exposure to therapeutic radioactive iodine (RAI) is associated with an increased relative risk of myeloid malignancies. Clonal hematopoiesis (CH) is a precursor state that can be detected in blood of healthy individuals decades before overt development of leukemia. We prospective studied the effects of RAI on CH. Prospective cohort study. We examined the effect of RAI on CH in 20 patients exposed to RAI for thyroid carcinoma and 20 age-matched unexposed controls. CH status was determined at baseline, 6, 12, 18 and 24 months. We also examined the effect of CH on structural progression of disease. No CH mutations were observed in the patient population that were not present at baseline. Using a variant allelic fraction (VAF) of 2% to define CH, 6/20 older patients (55-80 years old) had CH compared to 2/20 younger patients (20-40 years old) (p = 0.11). Six patients exposed to RAI had CH compared to two patients not exposed to RAI (30% vs. 10%, p = 0.11). There was no significant difference in CH VAF increase in patients treated with RAI compared to untreated age-matched controls (3.8% vs. 1.2%, p = 0.2). CH was significantly associated with somatic BRAFV600E mutations and with worse progression-free survival in the overall cohort as well as among BRAFV600E-mutant tumors. There was no increase in CH in patients treated with RAI over a 2-year follow-up period. Larger studies with longer follow-up periods are needed to investigate the association between RAI and clonal dynamics. The presence of CH is associated with worse structural progression in both BRAFV600E-mutant and wild-type thyroid cancers.

O-173 Decline in anti-Müllerian hormone (AMH) concentrations following radioactive iodine (RAI) treatment in women with differentiated thyroid cancer (DTC): a systematic review and meta-analysis

Abstract Study question Does radioactive iodine (RAI) treatment in premenopausal women with differentiated thyroid cancer (DTC) affects ovarian reserve, as evaluated by anti-Müllerian hormone (AMH), antral follicle count (AFC) and follicle-stimulating hormone (FSH)? Summary answer AMH concentrations decreased at three, six and 12 months following RAI treatment in women with DTC, whereas no difference was observed regarding FSH. What is known already Thyroid cancer is the third most common type of female malignancy and DTC is the most common histopathological type. Thyroidectomy constitutes the mainstay of treatment for DTC, followed by administration of RAI, which acts as an adjuvant therapy to destroy residual cancerous thyroid tissue. However, the effect of RAI on ovarian reserve of these women, as assessed by AMH, AFC and FSH, remains controversial. Study design, size, duration A systematic review and meta-analysis was performed aiming to identify studies evaluating the effect of RAI treatment on ovarian reserve in women with DTC. For this purpose, a literature search in the electronic databases PubMed, Scopus and CENTRAL was carried out until 06/12/2020. The primary outcome measure was the effect of RAI on ovarian reserve, as evaluated by AMH, AFC and FSH. Participants/materials, setting, methods Studies were eligible if they included premenopausal women with DTC, treated with a single RAI dose and assessed for at least one marker of ovarian reserve repeatedly within 12 months post-RAI.Meta-analysis of weighted data was performed using random effects model. Results were reported as weighted mean difference (WMD) with 95% confidence interval (CI). Main results and the role of chance Four prospective eligible studies, published between 2005 and 2020, were eligible for the meta-analysis, evaluating a total of 154 women. The number of participants ranged from 24 to 50. The single dose of RAI used to treat DTC ranged from 50 to 150 mCi. AMH concentrations decreased at three (WMD -1.66 ng/ml, 95% CI -2.42 to -0.91, p < 0.0001; I2 0%), six (WMD -1.58 ng/ml, 95% CI -2.63 to -0.52, p = 0.003; I2 54.7%) and 12 months (WMD -1.62 ng/ml, 95% CI -2.02 to -1.22, p < 0.0001; I2 15.5%) following a single RAI dose compared with baseline (three studies; n = 104). With respect to FSH concentrations, no difference was observed at six (WMD +3.29 IU/l, 95% CI -1.12 to + 7.70, p = 0.14; I2 96.8%) and 12 months (WMD +0.13 IU/l, 95% CI -1.06 to + 1.32, p = 0.83; I2 55.2%) post-RAI compared with baseline (two studies; n = 83). No data on AFC was available. Limitations, reasons for caution The small number of studies and patients included, as well as the lack of data on AFC may have compromised the validity of the conclusions drawn. Moreover, subgroup analysis according to female age was not feasible, due to the lack of relevant data. Wider implications of the findings The negative effect of RAI on ovarian reserve in premenopausal women with DTC, as indicated by the decreased AMH, should be confirmed by data on AFC, which are currently not available. These findings necessitate close monitoring of ovarian reserve in such women, counselling them regarding the need for fertility preservation. Trial registration number N/A

Thyroid Hürthle Cell Carcinoma: Clinical, Pathological, and Molecular Features.

Simple SummaryHürthle cell carcinoma (HCC) represents 3–4% of thyroid carcinoma cases. It is characterized by its large, granular and eosinophilic cytoplasm, due to an excessive number of mitochondria. Hürthle cells can be identified only after fine needle aspiration cytology biopsy or by histological diagnosis after the surgical operation. Published studies on HCC indicate its putative high aggressiveness. In this article, current knowledge of HCC focusing on clinical features, cytopathological features, genetic changes, as well as pitfalls in diagnosis are reviewed in order to improve clinical management.Hürthle cell carcinoma (HCC) represents 3–4% of thyroid carcinoma cases. It is considered to be more aggressive than non-oncocytic thyroid carcinomas. However, due to its rarity, the pathological characteristics and biological behavior of HCC remain to be elucidated. The Hürthle cell is characterized cytologically as a large cell with abundant eosinophilic, granular cytoplasm, and a large hyperchromatic nucleus with a prominent nucleolus. Cytoplasmic granularity is due to the presence of numerous mitochondria. These mitochondria display packed stacking cristae and are arranged in the center. HCC is more often observed in females in their 50–60s. Preoperative diagnosis is challenging, but indicators of malignancy are male, older age, tumor size > 4 cm, a solid nodule with an irregular border, or the presence of psammoma calcifications according to ultrasound. Thyroid lobectomy alone is sufficient treatment for small, unifocal, intrathyroidal carcinomas, or clinically detectable cervical nodal metastases, but total thyroidectomy is recommended for tumors larger than 4 cm. The effectiveness of radioactive iodine is still debated. Molecular changes involve cellular signaling pathways and mitochondria-related DNA. Current knowledge of Hürthle cell carcinoma, including clinical, pathological, and molecular features, with the aim of improving clinical management, is reviewed.

Abstract #803822: Effect of Radioactive Iodine on Hurthle Cell Thyroid Carcinoma

Abstract #803822: Effect of Radioactive Iodine on Hurthle Cell Thyroid Carcinoma

Заболеваемость аутоиммунным тироидитом в республике Беларусь и радиационный фактор

Actuality: In the Belarus, the primary incidence of thyroid pathology is in the 2d rank among endocrine diseases after diabetes. Studying the trends in the primary incidence of autoimmune thyroiditis (AIT) in the Belarus is important for improving organizational decisions and further improving the quality of medical care for the population.
 Purpose: Is to conduct a comparative analysis of the incidence of AIT in the population and in the affected population based on an epidemiological study in the Belarus, taking into account the radiation and organizational components in the formation of pathology.
 Material and methods: The data of the republican statistical reports and the data of the Chernobyl Register from 1997 to 2017 were analyzed. Standard methods of descriptive epidemiology were used in the work.
 Results: According to Chernobyl Registry, during the observation period (1997–2017), the primary incidence of AIT decreased by 1.4 times (1997 – 135.1 ± 15.77 0/0000; 2017 – 98.4 ± 7.55 0/0000). The incidence was statistically significantly higher in women than men (ratios ranged from 2.39: 1 in 2004 to 4.0: 1 in 2000). Moreover, the incidence according to Chernobyl Registry was higher than in the adult population, but in children where was no difference with population data. This indicates a high-quality clinical examination of the children’s population. Two organizational and medical approaches have been formed in the republic. The first approach (Grodno, Brest, Minsk regions and Minsk) is characterized by periods of moderate growth, decline, and growth again. In the second approach (Vitebsk, Mogilev and Gomel regions), there are two periods when the increase in incidence sharply changes to decrease before the end of the study period. An analysis of the odds ratio allowed us to conclude that insignificant effect of radioactive iodine on the incidence of AIT in children at the time of the accident and its absence in the adult population.
 Conclusion: The study confirms the importance of the organizational component in the early diagnosis of AIT.

Monitoring and Evaluation of Thyroid Function Tests, Serum Electrolytes and Creatinine Levels Before and After 131I Therapy.

Serum electrolytes, Creatinine, and thyroid profile play an important role in 131I treated patients of thyroid disorders. To determine the effect of radioactive iodine (131I) on renal parameters, serum electrolytes and the correlation among TFT'S, creatinine, and chloride levels before and after I131 treatment in thyroid disorders. The study was performed on 55 patients of thyrotoxicosis with age ranging from 16-65 years (mean age= 41±14years and BMI=24.8±4.46). The significance of the differences between the results of 1st, 2nd, and 3rd-time serum analysis was assessed by paired Student's t-test. Association between parameters was assessed by Spearman correlation analysis. 40 patients were taking Carbimazole, and 15 were directly recommended for I131 therapy. Strongly significant variations were observed for TFT'S (T3=0.012, T4 =0.017, and TSH=0. 001) during the follow-up treatment. Before taking I131 (Serum analyzed at 1st time), there observed negative correlation of T3(r=-.46, p=0. 002) and TSH (r=-0.31, p=0.02) with creatinine, and positive correlation of TSH(r=0.29,p=0.02) with chloride. BMI was negatively correlated with potassium(r=-0.30, p=0.02). At the 2nd time (after stopping the Carbimazole), no correlation results were observed. Two months after oral administration of 131I, creatinine, and chloride level was significantly increased (p=0.000), (P=0. 03) respectively, but had no correlation with TFT'S. Our findings suggest that patients with goiter (diffused or toxic) have association of TFT'S and BMI with serum electrolytes and creatinine, 131I therapy is also associated with the increase in creatinine and chloride levels of patients leading to kidney problems.

Effect of repetitive potassium iodide on elderly rat’s thyroid

Background: Nuclear power plant emergencies had often been accompanied by radioactivity release into the environment, thyroid cancer is one of the major health consequences due to the effect of radioactive iodine (131I) that emits ϒ ray and β particles resulting in thyroid DNA damage and late onset thyroid cancer. Intake of a single dose of potassium iodide (KI) is recommended to reduce this risk. However in case of prolonged radioiodine release as noticed during Chernobyl and Fukushima accidents, more than one dose of KI may be basic to ensure adequate protection [1]. Whereas a single dose of KI is admitted to be safe, knowledge about the effects of repeated KI administration are scarce, few studies demonstrated the potential efficiency of repetitive KI intake in humans [2] and non-human primates [3] without hormonal variations. These studies are relevant in the field of radiation protection and give a base evidence of the possible use of repetitive KI. On the other hand, we have studies on rodents that showed an impact of chronic iodine excess on pituitary thyroid axis function [4]. Our previous work on adult male rats demonstrated the safety of repeated administration of KI over 8 days [5]. Indeed in the elderly persons KI administration in case of nuclear emergency remains a topic of debate, because of the possible impact in cardiovascular diseases. Thyroid hormones are well-known for their profound effects on cardiovascular function and metabolism; myocardial and vascular endothelial tissues have receptors for thyroid hormones and are sensitive even to subtle changes in the concentrations of circulating pituitary and/or thyroid hormones i.e. subclinical hypothyroidism and hyperthyroidism. It is well established that hyperthyroidism induces a hyper-dynamic cardiovascular state, which is associated with a faster heart rate, enhanced left ventricular systolic and diastolic function whereas hypothyroidism is characterized by the opposite changes. Atrial fibrillation is the most common cardiac arrhythmia in the elderly, the prevalence and incidence increase with advancing age [6]. Several interventional trials showed that treatment of subclinical thyroid diseases improves cardiovascular risk factors, which implies potential benefits for reducing cardiovascular events. Objective: The aim of this study is to assess the effects of repeated KI intake on the thyroid function of aged male rats. Methods: A twelve months old male rats were subjected to either KI or saline solution over 8 days. Clinical biochemistry, pituitary and thyroid hormones level, and thyroid genes expression were analyzed 30 days after the treatment discontinuation. Findings: urinary assessment shows a subtle increase of some parameters (Creatinin, Uric Acid, Urea, Glucose, Potassium, Sodium and Chlorine), plasma biochemistry reveals a subtle variation of some parameters (an increase of Creatinin, Glucose and phosphorus; and a decrease of Chlorine level). Regarding pituitary-thyroid hormones we get a significant decrease of TSH level without thyroid hormones variation. At the molecular level, we observe a significant increase of TPO (+100%), AIT (+299%) and Tg (+38%) mRNA expression. On the other hand we get a significant decrease of TSHR (-51%) mRNA expression. Conclusion and perspectives: Our first results indicate that repeated KI intake affects the clinical biochemistry and the pituitary-thyroid axis function in elderly rats. To go further we are investigating the impact of these variations on the cardiovascular function and its parameters. Cardiac output data, cardiovascular gene expression, oxidative stress and inflammatory analysis are being processed. This study will contribute to the evolution of iodine policy and the harmonization of the current KI guidelines.

The effect of radioactive iodine therapy on urine sterilization in patients with differentiated thyroid cancer

Background: Urinary tract infection is the most common infection which necessitates antibiotics prescription. On the other hand, the appearance of antimicrobial resistance is one of the major health problems due to irrational antibiotic administration. Radio iodine therapy, using I-131 following thyroidectomy, is the standard treatment for the patients with differentiated thyroid cancer (DTC). After the consumption of radioactive iodine, it mainly excretes through the urinary system. This study is aimed to assess the effect of radioactive iodine (I-131) in the eradication of asymptomatic bacteriuria (ABU). Methods: Between September 2015 and May 2017, all the patients with DTC who were hospitalized to Nuclear Medicine Department for radio iodine ablation therapy were enrolled in the study. Urine analysis and culture were done for all the patients before iodine administration. If the result of the urine assessment was positive for the infection, urine culture repeated 1 week later and compare with pre-treatment results. Results: Of 182 patients, 10 cases had abnormal urine culture results. Five patients had CFU under 100,000, therefore was not considered as ABU; however, two of these patients had sterile urine after the treatment. Our only positive case had post treatment sterile urine. Conclusion: Considering radioactive iodine urine excretion, high radiation induced by radioactive iodine that passes through urinary tract may eradicate infection of genitourinary system

The Impact of Pathologically Positive Lymph Nodes in the Clinically Negative Neck: An Analysis of 39,301 Patients with Papillary Thyroid Cancer.

Management of patients with low-risk papillary thyroid cancer (PTC) with clinically uninvolved lymph nodes (cN0 LNs), but who harbor metastatic central LNs (pN1a), remains unclear. The number of central LNs examined, radioactive iodine (RAI) utilization, and survival were compared across cN0 patients based on pN stage: pN0 (negative) versus pNx (unknown) versus pN1a (pathologically positive). Adults with a PTC≥1cm who were cN0 preoperatively were compared based on surgical pathology using the National Cancer Data Base (NCDB; 2003-2011), after univariate and multivariate adjustment. Overall survival (OS) was examined using Kaplan-Meier curves, the log-rank test, and Cox proportional hazards modeling. Overall, 39,301 patients were included; median tumor size was 1.9cm. More LNs were examined for pN1a versus pN0 diagnosis (pN1a median=5 LNs vs. pN0 median=2 LNs; p<0.0001), with a median of two central LNs found to be positive on surgical resection. Compared with pN0, pN1a patients were 78% more likely to receive RAI (odds ratio 1.78, 95% confidence interval [CI] 1.65-1.91; p<0.0001). After adjusting for receipt of RAI, no difference in OS was observed for pN1a versus pN0 or pNx patients (p=0.72). Treatment with RAI was associated with improved OS (hazard ratio 0.78, 95% CI 0.62-0.98, p=0.03), but the effect of RAI did not differ based on pN stage (interaction p=0.67). More LNs were examined for positive versus negative pN diagnosis in patients with cN0 PTC. Unsuspected central neck nodal metastases in cN0 PTC patients are associated with increased RAI utilization, but no survival difference.

The effects of radioactive iodine therapy on olfactory function.

To determine the possible adverse effects of radioactive iodine (RAI) treatment on the olfactory functions of patients with differentiated thyroid carcinoma. This prospective clinical study included 63 Turkish patients who had been diagnosed with papillary thyroid carcinoma only to ensure homogeneity. The Connecticut Chemosensory Clinical Research Center olfactory test was administered at 1 week before treatment and at the third week and the first year after treatment. Triiodothyronine, thyroxine, thyroid stimulating hormone, thyroglobulin, and antithyroglobulin levels were measured 1 week before treatment and 2 weeks after treatment. The smell threshold test, smell identification test, and total smell scores showed statistically significant decreases after treatment when compared with the pretreatment scores (p = 0.000). No significant differences were noted between the late term and early term after RAI for either the identification score (p = 0.502) or the total score (p = 0.051). The Spearman correlation analysis indicated a significant correlation between age and RAI before and after treatment for the smell threshold test, smell identification test, and total smell scores (p < 0.05). A total of 54% of the patients displayed normosmia in the posttreatment period. A few patients had mild hyposmia before RAI, 27% had mild hyposmia in the early stage after RAI, and 29% had mild hyposmia in the late stage. The olfactory function deteriorated in almost half of the patients in the early stage after RAI. Mild and moderate hyposmia in particular occurred in the first year after RAI.

Abstract 183: BRAF oncogene induces miR-17-92 cluster in thyroid cells and iodine counteracts this effect

Abstract Background: High dose iodine intake is used as a prophylactic measure to protect thyroid from deleterious effects of radioactive iodine in case of nuclear accidents. In vitro, high concentration iodine delays oncogenic effects of RET/PTC3 in thyroid follicular cells, although its role during BRAF oncogene activation remains unclear. BRAF mutation (T1799A) is the most prevalent alteration during thyroid follicular cells oncogenesis leading to thyroid cancer. BRAFT1799A is associated to aggressive thyroid tumors and poor prognosis. High levels of microRNAs (miRNAs) miR-17-5p, miR-17-3p, miR-18a, miR-19a, miR-20a, miR-19b and miR-92, components of miR-17-92 cluster, are associated with several aggressive tumors such as lung cancer and thyroid carcinoma. Aberrant miRNA expression may cooperate to tumorigenesis as it regulates protein levels of different target mRNA from several signaling pathways. Therefore, in this study we aim at analyzing the role of iodine in miRNAs activated by BRAFT1799A oncogene. Methods: Cell culture and treatment: BRAF9-6 cells derived from rat thyroid follicular cells express conditionally BRAFT1799A in the presence of doxaciclin (Dox, at 1µg/mL). Early BRAFT1799A activation was analyzed after 48 hours of induction (Dox group). Five-days long iodine treatment was performed using culture media containing 10-5M sodium iodide (NaI group), and dox was added at day 3 (Dox+NaI group). Control group (Ctr) was performed in the absence of Dox and NaI; gene expression: detection of miR-18a, miR-19a, miR-19b and snoRNA was performed by qPCR. protein levels: Smad4 protein expression was investigated by Western-blotting using specific monoclonal antibodies against Smad4. Alfa-tubulin was detected as load control. Results: Early effects of BRAFT1799A in miRNA expression involve activation of miR-17-92 cluster in thyroid follicular cells. Conditional induction of BRAFT1799A (Dox group) results in a 85.8- fold, 634.3 fold and 141.6-fold increase in miR-19a, miR-19b and miR-18a, respectively, compared to control (Ctr group). Moreover, treating cells with iodine before BRAF activation (Dox+NaI group) resulted in partial or complete abrogation of this effect, with expression levels of miR-18a, miR-19a and miR-19b in 2.7-fold, 2.36-fold and 0.66-fold of Ctr group, respectively. Bioinformatic target prediction for miR-19a and miR-19b shows that Smad4 mRNA contain predicted binding sites in the 3′-UTR for these miRNAs. Smad4 is the key transducer of TGFB inhibitory signalling, frequently misbalanced in cancer. BRAF induction reduced Smad4 protein levels, effect abolished by previous iodine treatment, suggesting Smad4 as a possible target of miR-19a and miR-19b. Conclusion: Iodine exerts a protective effect in thyroid follicular cells, abrogating BRAFT1799A induced activation of miR-17-92 cluster key oncogenic miRNAs, miR-19a and miR-19b, and restoring Smad4 protein levels. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 183. doi:1538-7445.AM2012-183

The Effectiveness of Radioactive Iodine for Treatment of Low-Risk Thyroid Cancer: A Systematic Analysis of the Peer-Reviewed Literature from 1966 to April 2008

The Effectiveness of Radioactive Iodine for Treatment of Low-Risk Thyroid Cancer: A Systematic Analysis of the Peer-Reviewed Literature from 1966 to April 2008

A systematic review examining the effects of therapeutic radioactive iodine on ovarian function and future pregnancy in female thyroid cancer survivors

For women with differentiated thyroid carcinoma (DTC), the effect of radioactive iodine (RAI) therapy on gonadal and reproductive function is an important consideration. We systematically reviewed controlled studies examining the gonadal and reproductive effects of RAI therapy in women and adolescents surviving DTC. We searched nine electronic databases. All abstracts and papers were independently reviewed by two reviewers. After reviewing 349 unique citations and 61 full-text papers, 16 papers including data from 3023 women or adolescents with DTC were included. All studies were observational, with no long-term randomized control trial data. The age at first RAI treatment varied from 8 to 50 years and the cumulative activities of RAI administered for treatment varied from 30 to 1099 mCi. Transient absence of menstrual periods occurred in 8-27% of women within the first year after RAI, particularly in older women. In addition, RAI-treated women experienced menopause at a slightly younger age than women not treated with RAI. In the first year after RAI therapy, several studies reported increased rates of spontaneous and induced abortions. However, RAI treatment for DTC was generally not associated with a significantly increased risk of long-term infertility, miscarriage, induced abortions, stillbirths, or offspring neonatal mortality or congenital defects. In female survivors of DTC, there is little observational evidence to suggest important adverse effects of RAI treatment on gonadal function, fertility or pregnancy outcomes beyond 12 months, with the exception of a possible slightly earlier age of menopause.

Review article: intra-arterial treatments in patients with hepatocellular carcinoma.

In Western countries, most of the patients with hepatocellular carcinoma (HCC) are not eligible for curative treatments. Intra-arterial treatments have a palliative effect that could lead to extensive tumour necrosis and therefore have been widely used. Arterial embolization, Lipiodol-targeted chemoembolization and intra-arterial injection of radioactive iodine mixed with Lipiodol provided promising results in terms of tumoral growth, but were also responsible for severe side-effects, particularly in patients with cirrhosis. Their influence on survival has been assessed by randomized trials with contradictory results. In patients with advanced cases, embolization alone has limited or no influence on survival, and chemoembolization provided a beneficial effect mostly in patients with viral liver diseases, without liver failure, and with an adequate portal flux. The effects of radioactive iodine either in the treatment of advanced cases or the prevention of recurrences after a curative treatment must be investigated further.

Effects of radioactive iodine ( 131I) on the thyroid of newborn, pubertal and adult rats

Age is a potent modifier of thyroid cancer. The short latency for the development of thyroid cancer in the post-Chernobyl cases proposes that we need to be sure of the thyroid susceptibility to internal exposure, especially at young ages. We started a large-scale carcinogenesis project 6 years ago with the purpose to evaluate the carcinogenic potential of 131I when irradiated at young ages. First, we established a method to estimate the absorbed doses in the thyroid of different age groups. Irradiation at 1 week of age caused heavier exposure than at 4 and 9 weeks of age by eight times, while damages of the thyroid tissue were more obvious in the 4-week-old groups than in the 1-week-old groups. Second, we tested the responsiveness of thyroid epithelium to radiation. Apoptosis was not detected in the 1-week-old-thyroid epithelium, however, it did appear in the 4-week-old thyroid epithelium. While the proliferating cell nuclear antigen (PCNA)-labeling index was vice versa. Third, the carcinogenesis of 131I has been tested. Papillary carcinomas have developed in rats internally irradiated with 131I at the age of 1 week. A very low dose rate of irradiation by 131I could induce thyroid carcinomas with a short latency.

Timing for repeated treatment of hyperthyroid disease with radioactive iodine after initial treatment failure.

It has been reported that the effect of radioactive iodine (RAI) treatment is complete in 4 to 6 months. This retrospective study evaluated the appropriate time for repeated treatment of hyperthyroid disease with RAI after initial treatment failure. Outcomes of 128 patients treated with RAI for hyperthyroid disease were reviewed retrospectively at 3 and 6 months. Eighty patients (group A) were treated successfully with a single dose of RAI. Twenty patients (group B) required a second treatment dose. Twenty-eight patients were lost to follow-up. All patients in group A were clinically improved to various degrees at 3 months and continued to improve at 6 months. All eight patients in group B who showed no improvement at 3 months remained the same at 6 months. The difference between the two groups was statistically significant. Patients with hyperthyroid disease who are unimproved at 3 months can be retreated with RAI without further delay.