Search Results
You are looking at 1 - 2 of 2 items for :
- Author: Francesca Bianchi x
- Thyroid cancer - clinical x
Search for other papers by Carla Gambale in
Google Scholar
PubMed
Search for other papers by Alessandro Prete in
Google Scholar
PubMed
Search for other papers by Lea Contartese in
Google Scholar
PubMed
Search for other papers by Liborio Torregrossa in
Google Scholar
PubMed
Search for other papers by Francesca Bianchi in
Google Scholar
PubMed
Search for other papers by Eleonora Molinaro in
Google Scholar
PubMed
Search for other papers by Gabriele Materazzi in
Google Scholar
PubMed
Search for other papers by Rossella Elisei in
Google Scholar
PubMed
Search for other papers by Antonio Matrone in
Google Scholar
PubMed
Background
Second 131I treatment is commonly performed in clinical practice in patients with differentiated thyroid cancer and biochemical incomplete or indeterminate response (BiR/InR) after initial treatment.
Objective
The objective of the is study is to evaluate the clinical impact of the second 131I treatment in BiR/InR patients and analyze the predictive factors for structural incomplete response (SiR).
Patients and methods
One hundred fifty-three BiR/InR patients after initial treatment who received a second 131I treatment were included in the study. The clinical response in a short- and medium- long-term follow-up was evaluated.
Results
After the second 131I treatment (median 8 months), 11.8% patients showed excellent response (ER), 17% SiR, while BiR/InR persisted in 71.2%. Less than half (38.5%) of SiR patients had radioiodine-avid metastases. Patients who, following the second 131I treatment, experienced SiR had larger tumor size and more frequently aggressive histology and vascular invasion than those experienced BiR/InR and ER. Also, the median values of thyroglobulin on levothyroxine therapy (LT4-Tg), Tg peak after recombinant human TSH stimulation (rhTSH-Tg) and thyroglobulin antibodies (TgAb) were significantly higher in patients who developed SiR. At last evaluation (median: 9.9 years), BiR/InR persisted in 57.5%, while 26.2% and 16.3% of the patients showed ER and SiR, respectively. About half of BiR/InR patients (71/153 (46.4%)) received further treatments after the second 131I treatment.
Conclusions
Radioiodine-avid metastatic disease detected by the second 131I is an infrequent finding in patients with BiR/InR after initial treatment. However, specific pathologic and biochemical features allow to better identify those cases with higher probability of developing SiR, thus improving the clinical effectiveness of performing a second 131I treatment.
Search for other papers by Luciana Puleo in
Google Scholar
PubMed
Search for other papers by Laura Agate in
Google Scholar
PubMed
Search for other papers by Irene Bargellini in
Google Scholar
PubMed
Search for other papers by Giuseppe Boni in
Google Scholar
PubMed
Search for other papers by Paolo Piaggi in
Google Scholar
PubMed
Search for other papers by Claudio Traino in
Google Scholar
PubMed
Search for other papers by Tommaso Depalo in
Google Scholar
PubMed
Search for other papers by Giulia Lorenzoni in
Google Scholar
PubMed
Search for other papers by Francesca Bianchi in
Google Scholar
PubMed
Search for other papers by Duccio Volterrani in
Google Scholar
PubMed
Search for other papers by Sandra Brogioni in
Google Scholar
PubMed
Search for other papers by Valeria Bottici in
Google Scholar
PubMed
Search for other papers by Maurizia Rossana Brunetto in
Google Scholar
PubMed
Search for other papers by Barbara Coco in
Google Scholar
PubMed
Search for other papers by Eleonora Molinaro in
Google Scholar
PubMed
Search for other papers by Rossella Elisei in
Google Scholar
PubMed
Objectives
Liver metastases occur in 45% of patients with advanced metastatic medullary thyroid cancer (MTC). Transarterial radioembolization (TARE) has been proposed to treat liver metastases (LM), especially in neuroendocrine tumors. The aim of this study was to investigate the biochemical (calcitonin and carcino-embryonic antigen) and objective response of liver metastases from MTC to TARE.
Methods
TARE is an internal radiotherapy in which microspheres loaded with β-emitting yttrium-90 (90Y) are delivered into the hepatic arteries that supply blood to LM. Eight patients with progressive multiple LM underwent TARE and were followed prospectively. They were clinically, biochemically and radiologically evaluated at 1, 4, 12 and 18 months after TARE.
Results
Two patients were excluded from the analysis due to severe liver injury and death due to extrahepatic disease progression, respectively. One month after TARE, a statistically significant (P = 0.02) reduction of calcitonin was observed in all patients and remained clinically relevant during follow-up; reduction of CEA, although not significant, was found in all patients. Significant reduction of liver tumor mass was observed 1, 4 and 12 months after TARE (P = 0.007, P = 0.004, P = 0.002, respectively). After 1 month, three of six patients showed partial response (PR) and three of six stable disease (SD) according to RECIST 1.1, while five of six patients had a PR and one of six a SD according to mRECIST. The clinical response remained relevant 18 months after TARE. Excluding one patient, all others showed only a slight and transient increase in liver enzymes.
Conclusions
TARE is effective in LM treatment of MTC. The absence of severe complications and the good tolerability make TARE a valid therapeutic strategy when liver LM are multiple and progressive.
