Evolución del tratamiento con radioyodo en el carcinoma diferenciado de tiroides

  • Pilar Tamayo-Alonso
    Servicio de Medicina Nuclear. Hospital Universitario de Salamanca. Instituto de Investigación Biomédica de Salamanca (IBSAL) https://orcid.org/0000-0002-7466-514X ptamayo[at]usal.es
  • Paloma García-Talavera
    Servicio de Medicina Nuclear. Hospital Universitario de Salamanca https://orcid.org/0000-0001-7746-7555
  • Carlos Montes-Fuentes
    Servicio de Física Médica. Hospital Universitario de Salamanca. Instituto de Investigación Biomédica de Salamanca (IBSAL) https://orcid.org/0000-0002-1728-5706
  • Esther Martín-Gómez
    Servicio de Medicina Nuclear. Hospital Universitario de Salamanca https://orcid.org/0000-0001-6019-5928
  • Enrique Martín-Gómez
    Servicio de Medicina Nuclear. Hospital Universitario de Salamanca
  • Luis Díaz-González
    Servicio de Medicina Nuclear. Hospital Universitario de Salamanca. Instituto de Investigación Biomédica de Salamanca (IBSAL)


En marzo de 2021 se ha celebrado el 80 aniversario de la primera aplicación terapéutica del radioyodo (RAI) por Saúl Hertz a una paciente con hipertiroidismo el 31 de marzo de 1936. El éxito alcanzado impulsó su utilización en el tratamiento del carcinoma diferenciado de tiroides (CDT) y supuso un cambio de paradigma en el manejo de las enfermedades tiroideas. Desde entonces, han cambiado las estrategias de administración de RAI a pacientes con CDT y aún hoy día existen controversias. En esta revisión vamos a comentar las diferentes estrategias adoptadas en la administración de RAI a pacientes con CDT a lo largo de estas 8 décadas y cuáles son las controversias actuales en cuanto a qué pacientes con CDT hay que administrar RAI y qué actividad de RAI se debe administrar.
  • Referencias
  • Cómo citar
  • Del mismo autor
  • Métricas

Fahey FH, Grant FD, Thrall JH. Saul Hertz, MD, and the birth of radionuclide therapy. Vol. 4, EJNMMI Physics. 2017. p. 15.

Hertz S, Roberts A. Radioactive iodine in the study of thyroid physiology; the use of radioactive iodine therapy in hyperthyroidism. J Am Med Assoc. 1946 May;131:81–6.

Howell JD. A history of the American Society for Clinical Investigation. J Clin Invest. 2009 Apr;119(4):682–97.

Seidlin SM, Marinelli LD, Oshry E. Radioactive iodine therapy; effect on functioning metastases of adenocarcinoma of the thyroid. J Am Med Assoc. 1946 Dec;132(14):838–47.

Surks MI. Milestones in thyroid research at Montefiore Medical Center, 1920-2011: history and personal reflections. Endocr Pract. 2013;19(1):172–4.

Ehrhardt JDJ, Güleç S. A Review of the History of Radioactive Iodine Theranostics: The Origin of Nuclear Ontology. Mol Imaging Radionucl Ther. 2020 Oct;29(3):88–97.

Fitzgerald PJ, Foote FWJ, Hill RF. Concentration of I131 in thyroid cancer, shown by radioautography; a study of 100 consecutive cases showing the relation of histological structure to the function of thyroid carcinoma. Cancer. 1950 Jan;3(1):86–105.

Bierwaltes W, Johson P, Solari AJ. Clinical use of radioisotopes. Philadelphia: W.B. Saunders Co; 1957. 150 p.

Haynie TP, Nofal MM, Beierwaltes WH. Treatment of thyroid carcinoma with I-131. Results at fourteen years. JAMA. 1963 Feb;183:303–6.

Bierwaltes W. Love of life:autobiographical sketches. New York: Vantage Press; 1996. 76–77 p.

Slonimsky E, Tulchinsky M. Radiotheragnostics Paradigm for Radioactive Iodine (Iodide) Management of Differentiated Thyroid Cancer. Curr Pharm Des. 2020;26(31):3812–27.

Benua RS, Cicale NR, Sonenberg M, Rawson RW. The relation of radioiodine dosimetry to results and complications in the treatment of metastatic thyroid cancer. Am J Roentgenol Radium Ther Nucl Med. 1962 Jan;87:171–82.

Beierwaltes WH, Rabbani R, Dmuchowski C, Lloyd R V, Eyre P, Mallette S. An analysis of “ablation of thyroid remnants” with I-131 in 511 patients from 1947-1984: experience at University of Michigan. J Nucl Med. 1984 Dec;25(12):1287–93.

Deandreis D, Rubino C, Tala H, Leboulleux S, Terroir M, Baudin E, et al. Comparison of Empiric Versus Whole-Body/-Blood Clearance Dosimetry-Based Approach to Radioactive Iodine Treatment in Patients with Metastases from Differentiated Thyroid Cancer. J Nucl Med. 2017 May;58(5):717–22.

Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2016 Jan;26(1):1–133.

Tuttle RM, Tala H, Shah J, Leboeuf R, Ghossein R, Gonen M, et al. Estimating risk of recurrence in differentiated thyroid cancer after total thyroidectomy and radioactive iodine remnant ablation: using response to therapy variables to modify the initial risk estimates predicted by the new American Thyroid Association staging system. Thyroid. 2010 Dec;20(12):1341–9.

Van Nostrand D. Selected Controversies of Radioiodine Imaging and Therapy in Differentiated Thyroid Cancer. Endocrinol Metab Clin North Am. 2017 Sep;46(3):783–93.

Tuttle RM, Ahuja S, Avram AM, Bernet VJ, Bourguet P, Daniels GH, et al. Controversies, Consensus, and Collaboration in the Use of (131)I Therapy in Differentiated Thyroid Cancer: A Joint Statement from the American Thyroid Association, the European Association of Nuclear Medicine, the Society of Nuclear Medicine and Molecular Imaging, and the European Thyroid Association. Thyroid. 2019 Apr;29(4):461–70.

Mazzaferri EL, Jhiang SM. Long-term impact of initial surgical and medical therapy on papillary and follicular thyroid cancer. Am J Med. 1994 Nov;97(5):418–28.

Hay ID, Johnson TR, Kaggal S, Reinalda MS, Iniguez-Ariza NM, Grant CS, et al. Papillary Thyroid Carcinoma (PTC) in Children and Adults: Comparison of Initial Presentation and Long-Term Postoperative Outcome in 4432 Patients Consecutively Treated at the Mayo Clinic During Eight Decades (1936-2015). World J Surg. 2018 Feb;42(2):329–42.

Leboulleux S, Tuttle RM, Pacini F, Schlumberger M. Papillary thyroid microcarcinoma: time to shift from surgery to active surveillance? Lancet Diabetes Endocrinol. 2016 Nov;4(11):933–42.

Sawka AM, Brierley JD, Tsang RW, Thabane L, Rotstein L, Gafni A, et al. An updated systematic review and commentary examining the effectiveness of radioactive iodine remnant ablation in well-differentiated thyroid cancer. Endocrinol Metab Clin North Am. 2008 Jun;37(2):457–80, x.

Sacks W, Fung CH, Chang JT, Waxman A, Braunstein GD. 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. Thyroid. 2010 Nov;20:1235–45.

Verburg FA, Ahuja S, Avram AM, Bardiès M, Bernet V, Bourguet P, et al. Brief progress report from the intersocietal working group on differentiated thyroid cancer. Vol. 47, European journal of nuclear medicine and molecular imaging. 2020. p. 1345–7.

Durante C, Montesano T, Attard M, Torlontano M, Monzani F, Costante G, et al. Long-term surveillance of papillary thyroid cancer patients who do not undergo postoperative radioiodine remnant ablation: is there a role for serum thyroglobulin measurement? J Clin Endocrinol Metab. 2012 Aug;97(8):2748–53.

Differentiated thyroid cancer: Is there a need for radioiodine ablation in low risk patients? (ESTIMABL2). ClinicalTrials.gov website, [Internet]. Published April 23. 2013 [cited 2018 Jul 29]. Available from: https://clinicaltrials.gov/ct2/show/NCT01398085.

Mallick U, Harmer C, Hackshaw A, Moss L. Iodine or Not (IoN) for low-risk differentiated thyroid cancer: the next UK National Cancer Research Network randomised trial following HiLo. Clin Oncol (R Coll Radiol). 2012 Apr;24(3):159–61.

Leboulleux S, Bournaud C, Chougnet CN, Zerdoud S, Catargi BN, Cao C Do, et al. Estimabl2: Is There a Need for Radioiodine Ablation in Low Risk Differentiated Thyroid Cancer (DTC) Patients?: Results From the French Randomized Phase III Prospective Trial on 776 Patients (NCT 01837745). J Endocr Soc. 2021;5(Supplement_1):A875–A875.

Schlumberger M, Leboulleux S. Current practice in patients with differentiated thyroid cancer. Nat Rev Endocrinol. 2021 Mar;17(3):176–88.

Verburg FA, Flux G, Giovanella L, van Nostrand D, Muylle K, Luster M. Differentiated thyroid cancer patients potentially benefitting from postoperative I-131 therapy: a review of the literature of the past decade. Eur J Nucl Med Mol Imaging. 2020 Jan;47(1):78–83.

Mallick U, Harmer C, Yap B, Wadsley J, Clarke S, Moss L, et al. Ablation with low-dose radioiodine and thyrotropin alfa in thyroid cancer. N Engl J Med. 2012 May;366(18):1674–85.

Schlumberger M, Catargi B, Borget I, Deandreis D, Zerdoud S, Bridji B, et al. Strategies of radioiodine ablation in patients with low-risk thyroid cancer. N Engl J Med. 2012 May;366(18):1663–73.

Schlumberger M, Leboulleux S, Catargi B, Deandreis D, Zerdoud S, Bardet S, et al. Outcome after ablation in patients with low-risk thyroid cancer (ESTIMABL1): lancet Diabetes Endocrinol. 2018 Aug;6(8):618–26.

Dehbi H-M, Mallick U, Wadsley J, Newbold K, Harmer C, Hackshaw A. Recurrence after low-dose radioiodine ablation and recombinant human thyroid-stimulating hormone for differentiated thyroid cancer (HiLo): long-term results of an open-label, non-inferiority randomised controlled trial. lancet Diabetes Endocrinol. 2019 Jan;7(1):44–51.

Grani G, Zatelli MC, Alfò M, Montesano T, Torlontano M, Morelli S, et al. Real-World Performance of the American Thyroid Association Risk Estimates in Predicting 1-Year Differentiated Thyroid Cancer Outcomes: A Prospective Multicenter Study of 2000 Patients. Thyroid. 2021 Feb;31(2):264–71.

Durante C, Haddy N, Baudin E, Leboulleux S, Hartl D, Travagli JP, et al. Long-term outcome of 444 patients with distant metastases from papillary and follicular thyroid carcinoma: benefits and limits of radioiodine therapy. J Clin Endocrinol Metab. 2006 Aug;91(8):2892–9.

Giovanella L, Duntas LH. Management of endocrine disease: The role of rhTSH in the management of differentiated thyroid cancer: pros and cons. Eur J Endocrinol. 2019 Oct;181(4):R133–45.

Robbins RJ, Wan Q, Grewal RK, Reibke R, Gonen M, Strauss HW, et al. Real-time prognosis for metastatic thyroid carcinoma based on 2-[18F]fluoro-2-deoxy-D-glucose-positron emission tomography scanning. J Clin Endocrinol Metab. 2006 Feb;91(2):498–505.

Schlumberger M, Brose M, Elisei R, Leboulleux S, Luster M, Pitoia F, et al. Definition and management of radioactive iodine-refractory differentiated thyroid cancer. lancet Diabetes Endocrinol. 2014 May;2(5):356–8.

Pacini F, Fuhrer D, Elisei R, Handkiewicz-Junak D, Leboulleux S, Luster M, et al. 2022 ETA Consensus Statement: What are the indications for post-surgical radioiodine therapy in differentiated thyroid cancer? Eur Thyroid J. 2022 Jan;11(1).

Tamayo-Alonso, P., García-Talavera, P. ., Montes-Fuentes, C., Martín-Gómez, E., Martín-Gómez, E., & Díaz-González, L. (2022). Evolución del tratamiento con radioyodo en el carcinoma diferenciado de tiroides. Revista ORL, 13(2), e28343. https://doi.org/10.14201/orl.28343

Artículos más leídos del mismo autor/a


Los datos de descargas todavía no están disponibles.