MANAGEMENT OF THYROID-CARCINOMA WITH RADIOACTIVE I-131

Purpose: To evaluate the role of radioactive I-131 in the management o f patients with well differentiated carcinoma of the thyroid. Methods and Materials: Between 1965 and 1995, a total of 117 patients with wel l-differentiated carcinoma of the thyroid underwent either lobectomy o r thyroidectomy followed by 100-150 mCi of I-131. Results: With a medi an follow-up of 8 years, only four patients (3%) developed a recurranc e of their disease. The 5-year acturial survival was 97% with a 10-yea r survival of 91%. There were no severe side effects noted after I-131 therapy. Conclusions: Radioactive I-131 is a Safe and effective proce dure for the majority of patients with well-differentiated thyroid car cinoma. We currently recommend that all patients undergo a subtotal or total thyroidectomy follow ed by I-131 thyroid scanning approximately 4 weeks after surgery. If the thyroid scan shows no residual uptake a nd all disease is confined to the thyroid, we recommend following pati ents with annual thyroid scans and serum thyroglobulin levels. If ther e is any residual uptake detected in the neck or if the tumor extends beyond the thyroid, we recommend routine thyroid ablation of 100-150 m Ci of radioactive I-131.