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131I treatment of thyroid papillary carcinoma in a patient with renal failure

✍ Scribed by Donald W. Morrish; Larry J. Filipow; Alexander J. McEwan; Ronald Schmidt; Keith R. Murland; Christian Von Westarp; Kelvin B. Betcher

Publisher
John Wiley and Sons
Year
1990
Tongue
English
Weight
503 KB
Volume
66
Category
Article
ISSN
0008-543X

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✦ Synopsis

Procedures for 13'1 ablation in renal failure are not known. In one patient receiving dialysis, detailed dosimetry and health safety aspects were obtained. The results showed insignificant contamination of equipment, but a surprisingly significant reduction in biologic half-life of I3'I due to efficient dialysis extraction. The data indicate that 13'1 ablation can be done safely and easily during dialysis but that much higher 13'1 doses must be used to achieve equivalent results to those obtained in patients with normal renal function. Cancer 662509-2513.1990.

HE CURRENT ACCEPTED TREATMENT for ablation of

T thyroid remnants or metastatic papillary carcinoma of the thyroid is I3'I

The treatment schedules and dosimetry of I3'I have been well studied in persons with normal renal f ~n c t i o n . ~-~ However, only one report of 13'1 ablation in a patient undergoing renal dialysis has been r e p ~r t e d , ~ and no radiation dosimetry or health safety aspects were documented. Because l 3 'I undergoes renal excretion, there is concern regarding the safety and feasibility of I3'I treatment in patients with renal failure. It is unknown if radiation dosimetry is different under these circumstances. In this report, we describe detailed studies of all these considerations in a patient receiving chronic hemodialysis who required I3'I treatment for metastatic papillary carcinoma of the thyroid.

Case Report

A 36-year-old man had a right nephrectomy at the age of 12 years due to trauma. At the age of 17 years he again sustained trauma, resulting in a splenectomy and transient renal failure. Complete renal failure subsequently occurred, and he underwent renal transplantation in 1974. Ten months later the transplant From the Departments of

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