RADIOIODINE TREATMENT OF METASTATIC THYROID-CARCINOMA - THE ROYAL-MARSDEN-HOSPITAL EXPERIENCE

The case records of 235 patients who were treated for differentiated thyroid cancer between 1949 and 1981 were reviewed. Forty-two (18%) had distant metastatic spread outside the neck and received radioiodine (131I) therapy. In cases where the distant spread was confined to the lungs, 54% of patient were alive, free of disease, 10 yr after 131I treatment was started. No patient with skeletal involvement has survived for 10 yr and only 1 for 5 yr after treatment. A variety of cytotoxic drugs was tried on an ad hoc basis with no notable success. One patient developed preleukemia 3 mo. after completion of 131I treatment, but no other serious side effects were observed. Factors that influence the behavior of metastatic thyroid carcinoma are discussed and a possible revised approach to 131I therapy is suggested in the light of these findings.