131I Treatment of Metastatic Thyroid Carcinoma Following Preparation by Recombinant Human Thyrotropin

Eradication of metastatic thyroid carcinoma is a challenge. This challenge is attributed to the marked reduction in iodine uptake and organification in thyroid cancer cells, the relatively slow and unpredictable rate of progression, and the generally high quality of life (QOL), even in those patients with widely metastatic lesions. Furthermore, relatively few studies have identified reliable predictors of the progression rate, the pattern of metastatic spread, or the sensitivity to 131I therapy. Patients and their physicians often continue to administer large amounts of 131I to lesions that appear iodine-avid, even in the absence of previous tumor responses. A common rationalization for this approach is that the subsequent progression would have been worse if another dose of 131I had not been administered.