Abstract
In 2010, the Ministry of Health, Labour and Welfare of Japan permitted radioiodine (I-131) therapy to be performed at outpatient departments for high-risk patients with differentiated thyroid cancer after total thyroidectomy. Accordingly, we started such therapy in 2011, and herein report the therapeutic problems and value of the therapy.
Three of 22 patients were not able to undergo the therapy because of difficulty of self-restriction of iodine uptake before the therapy, recurrence of additional cancer, or the possibility of radiation exposure to caregivers. Although the remaining 19 patients underwent the therapy, two of them became nervous about quickly starting the therapy in view of the radioactive contamination caused by the Fukushima nuclear power plant disaster after the Great East Japan Earthquake on March 11, 2011. Comparing the method of thyroid hormone suspension, the recombinant human thyroid stimulation hormone (rhTSH) method was acceptable to all patients in terms of complications. Tumor recurrence (3 cases) or distant metastasis (1 case) appeared in 19 cases, all of which had previously experienced cervical recurrence and some surgical operations. Therefore, the current radioiodine therapy may not be completely effective to prevent re-recurrence, although the present study had a short duration and a small number of patients.
