Abstract
Background and Aims
Patients with differentiated thyroid cancer are often advised to follow a low iodine diet (LID) one to two weeks before radioiodine remnant ablation (RRA). We describe treatment practices and ablation success rates in centres (C1, C2, C3) in the UK with different approaches to LID advice.
Methods
Historic cohort of patients with differentiated thyroid cancer treated with RRA in 2015/16 in C1 (n=50, 1-week LID), C2 (n=59, 2-week LID) and C3 (n=108, no LID advice). Response to RRA was stratified as excellent, indeterminate, or incomplete by the adapted American Thyroid Association Dynamic Risk Stratification Score.
Results
There was little difference in age, sex and staging between centres, but the percentage receiving 1.1GBq vs higher administered activities differed (C1:22%, C2:44%, C3:15%, p<0.001). Excellent response was recorded for: C1:48%, C2:36%, C3:49% (p=0.61). Differences in RRA preparation and outcome assessment at C3 precluded comparison across all centres. Adjusted odds ratio for excellent response at C2 vs C1 was 0.57 (95%CI: 0.25,1.32), p=0.19.
Conclusions
There was no evidence that advising a LID for 2-weeks before RRA improves outcomes compared to 1-week. For definitive recommendations on LIDs prior to RRA, a prospective multi-centre study with a more homogenous approach to patient management or, randomised controlled trial, is needed.
Patients with differentiated thyroid cancer are often advised to follow a low iodine diet (LID) one to two weeks before radioiodine remnant ablation (RRA). We describe treatment practices and ablation success rates in centres (C1, C2, C3) in the UK with different approaches to LID advice.
Methods
Historic cohort of patients with differentiated thyroid cancer treated with RRA in 2015/16 in C1 (n=50, 1-week LID), C2 (n=59, 2-week LID) and C3 (n=108, no LID advice). Response to RRA was stratified as excellent, indeterminate, or incomplete by the adapted American Thyroid Association Dynamic Risk Stratification Score.
Results
There was little difference in age, sex and staging between centres, but the percentage receiving 1.1GBq vs higher administered activities differed (C1:22%, C2:44%, C3:15%, p<0.001). Excellent response was recorded for: C1:48%, C2:36%, C3:49% (p=0.61). Differences in RRA preparation and outcome assessment at C3 precluded comparison across all centres. Adjusted odds ratio for excellent response at C2 vs C1 was 0.57 (95%CI: 0.25,1.32), p=0.19.
Conclusions
There was no evidence that advising a LID for 2-weeks before RRA improves outcomes compared to 1-week. For definitive recommendations on LIDs prior to RRA, a prospective multi-centre study with a more homogenous approach to patient management or, randomised controlled trial, is needed.
| Original language | English |
|---|---|
| Pages (from-to) | 315-320 |
| Number of pages | 6 |
| Journal | Clinical Nutrition ESPEN |
| Volume | 47 |
| Early online date | 23 Nov 2021 |
| DOIs | |
| Publication status | Published - 1 Feb 2022 |
Bibliographical note
Funding Information:This study was funded by the NIHR Bristol Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol . The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.
Funding Information:
This study was funded by the NIHR Bristol Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.
Publisher Copyright:
© 2021 European Society for Clinical Nutrition and Metabolism
Keywords
- Thyroid cancer
- Radioiodine ablation
- Historic studies
- Low iodine diet