Iodine-131 treatment of thyroid papillary carcinoma in patients undergoingdialysis for chronic renal failure: A dosimetric method

Until recently, the therapeutic protocol widely accepted for ablation of th e thyroid remnant and for metastases of thyroid papillary carcinoma was the administration of I-131 after surgery. However, at present, some data ques tion the usefulness of such treatment in patients considered low risk. The treatment with radioiodine in patients suffering from end-stage renal disea se (ESRD) undergoing hemodialysis requires controlled dosages and individua lized administration guidelines. The need to include these patients on the waiting list for a renal transplantation, once they have overcome the disea se, and the higher prevalence of thyroid carcinoma in ESRD patients makes t his an increasingly significant problem. The cases reported in the literatu re are few and the therapeutic models followed are very difficult. In this paper we propose a therapeutic model that provides the highest thyroid abla tive dosage, minimizing radiation exposure to the rest of the organs. The m ain difference between our protocol and that already described is the perfo rmance of daily hemodialysis during the first 5 days of treatment, as well as the administration of a dose of I-131 equivalent to that administered to patients who show normal renal function.