People with low-risk thyroid cancer may receive lower doses of radiation therapy: study

According to a recent study, hospitals can now treat people with low-risk thyroid cancer with lower radioactivity after surgery. Considered to be the world's oldest low-risk thyroid test in the UK, the suggested recommendations, once accepted, will likely benefit thousands of people. Dr. Jonathan Wadsley, Clinical Oncology Consultant at Weston Park Hospital in Sheffield and Chair of the National Cancer Research Institute's (NRC) Thyroid Cancer Subgroup, presented the results of this conference at the Organized Cancer Conference by the NCRI in 2018 in Glasgow.

The latest results showed that there was no significant difference in the rate of cancer recurrence between patients receiving a low dose of radiation compared to the higher standard dose. When patients had less activity, they experienced fewer side effects. According to the study, they were less likely to feel sick or suffer from salivary gland lesions, which could result in permanent dryness of the mouth. Reducing the dose reduces the risk of contracting cancer later, he added.

According to experts, many patients find it difficult to stay in isolation rooms at the hospital for two to three days without physical contact with friends or family members when they receive higher doses. When doses are high, radiation protection regulations require that the dose be reduced before releasing the patient from the isolation room. Health services save money when patients are not active. In addition, hospitals can treat more patients. Radiation protection enthusiasts approve for the treatment of the patient as little radioactivity as reasonably achievable without sacrificing clinical benefits.

AIIMS researchers in New Delhi are considered pioneers in this field. In 1996, AIIMS researchers conducted the first prospective randomized clinical trial of the administered dose for the destruction of the remaining cells. In addition to their study, two other studies were conducted in France (ESTIMABL group) and in the United Kingdom (HiLo study). The last two had a longer follow-up. Although doctors have used radioactive iodine to treat thyroid cancer for several decades, this remained an enigma.

In 2014, in a clinical journal of low-risk thyroid cancer published in the British Medical Journal, researchers noted that thyroid cancer is one of the fastest growing diagnoses. More are found each year than all leukemias and liver cancers. , pancreas and stomach. They found that most of these incidents were of papillary origin and were both small and localized. "Patients with these small, localized papillary thyroid cancers have a survival rate of 99% at 20 years. Given the excellent prognosis of these tumors, they have been described as low risk. The incidence of these low-risk thyroid cancers probably increases due to the use of imaging technologies capable of exposing a large reservoir of subclinical diseases, "they said.

The first step in the treatment of thyroid cancer is to remove the thyroid by surgery. Even an experienced surgeon can leave cancer cells and thyroid cells on the site. Some cells may move away. Doctors want to destroy any thyroid tissue and normal thyroid cancer cells after surgery. If doctors do not, the remaining cells can proliferate, resulting in cancer recurrence. Oncologists give radioactive iodine (I-131) as a liquid or capsule to prevent this. The radioisotope is concentrated in the thyroid cells of the body, wherever they are. Radiation emitted by radioactive iodine destroys the remaining cells of the thyroid after surgery.

Dr. Wadsley reported the results of 434 patients with low-risk thyroid cancer from 29 British hospitals participating in the HiLo trial, with a median (mean) follow-up period of 6.5 years. He confirmed to this author that many UK centers had already adopted the low-dose regimen to treat low-risk patients with thyroid cancer, following the release of the study's main result in 2012. "The more recently reported longer-term follow-up data have added to us. He is convinced that the use of the lower dose regimen does not lead to an increase in the long-term recurrence of thyroid cancer," he said. he affirmed. The Lancet Diabetes and Endocrinology has accepted the study for publication; it is currently the subject of a final editorial review.

According to Dr. Martin Forster of University College London, who chairs the NCRI's Head and Neck Clinical Study Group but did not participate in this research, "almost seven years of follow-up data from The HiLo trial allow us to believe that for patients with low-risk thyroid cancer is a safe and effective treatment, and international guidelines can be updated accordingly. For many patients, treatment and its mode of administration, as well as short- and long-term side effects, can have a significant impact on their lives. "