Endocrine Abstracts

BIOMAT-ENDO software is a Windows Forms application that stores all the main data regarding the patients with thyroid cancer (TC) hospitalized in the Nuclear Medicine Department of the National Institute of Endocrinology in Bucharest, starting with the first hospitalization, continuing with the periods of radioiodine therapy (RIT) and the follow up. Patient-monitoring MODULE contains clinical parameters, surgery details, in Vivo and in Vitro investigations, therapy information. Correlations can be done between any input data. Until now 2000 cases hospitalized during the last 50 years were digitalized in this data base.

Materials and methods: We selected 300 patients who had undergone a total thyroidectomy and subsequent I-131 therapy. Including criteria: at least two I-131 therapies, whole body scan result (WBS), serum TGL and AntiTGL values. Analysis also includes parameters associated with the curative effect: gender, age at diagnostic, risk factors (endemic/non-endemic area), environmental origin, surgical procedure, histopathologic diagnosis. We used Q15L to verify the correctness of existing data and for some statistical results.

Results: In the studied group there is a prevalence of DTC among women (84%) over 45 year, most of them from the urban area (70%). Endemic zones are the main area risk factor (70%). Preablative distribution of stimulated TGL values was: < 2–10 ng/ml (35%), 10–100 ng/ml (39%) and >100 ng/ml (26%) with mean value =107.93±278.25 ng/ml. Positive Anti TGL at the first RIT are present in 21% of patients. 96% of patients were with positive WBS. After the RIT (therapies number: 5.4±3.6, cumulative dose: 382.6±280 mCi) a significant decrease of TGL was found (mean 0.672 ng/ml, P< 0.01) at 82% of the cases. WBS results were negative for 81% of patients. Not responding cases, with high TGL values and positive WBS after RIT, represented 18%.

Conclusion: Our study indicates that most DTC patients can obtain partial or complete remission after I-131 therapy. I-131 imaging and TGL levels at diagnosis are both important indicators to evaluate the curative effect. The analysis of efficacy and prognostic factors of RIT have the benefit to establish individualized treatment strategy, predict curative effect and assess the prognosis for those DTC patients. The clinical data reviewed revealed which biological features are predominant for a good overall prognosis of thyroid cancer, which patients are still with persistent/ recurrent disease according to the measured serum thyroglobulin (TGL) levels and imagistic findings.