Retrospective analysis of the course of thyroid carcinoma with lung metastases after radioiodine therapy

Abstract

Metastasis of malignant tumors are one of the most acute problems of oncology. Among the organs and systems of the human body in terms of frequency of damage, one of the first places is occupied by the lungs, which is probably closely related to the anatomical features of their structure and physiology. During the first examination of cancer patients, metastases in the lungs are revealed in 6-15%, lymphogenous metastases are observed in 50-81%. With differentiated thyroid carcinoma (thyroid gland), metastases in the lung are most often detected (up to 15% of cases). At the same time, 5- and 10-year survival rates are 50-92.6% and 42-86%, respectively. The use of 131I-sodium iodide is central to the treatment of these patients. The purpose of the paper is to study the effectiveness of radioiodine therapy for metastases of thyroid carcinoma in the lung. We used clinical, laboratory, radiological methods for the diagnosis of thyroid carcinoma and pulmonary metastases. From 1986 to 2010, 68 patients from the clinic of the S.P. Hryhoriev Institute of Medical Radiology of the Academy of Medical Sciences of Ukraine were included in the study. Lung metastases were found in patients with all stages of the disease and with diverse sizes of the primary thyroid tumor. After the surgical treatment of patients, 131Isodium iodide was used in various doses of radioactivity. The full therapeutic effect of radiotherapy was achieved in 5 patients (7.8%) over a 3-year period of treatment, and a 5-year period – in 28 (43.8%); stabilization or partial effect was noted in 24 patients (37.8%), disease progression was observed in 12 patients (17.6%). Mortality from disease progression was 12.5%.