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Time course of Graves ’ orbitopathy after total thyroidectomy and radioiodine therapy for thyroid cancer

View Article: PubMed Central - PubMed

ABSTRACT

The risk of cancer is relatively higher in Graves’ patients presenting simultaneously with thyroid nodules. Radioiodine (RAI) therapy recommended in high-risk differentiated thyroid carcinoma may be associated with worsening of a pre-existing Graves’ orbitopathy (GO) or developing a new onset. The impact of RAI therapy in patients with differentiated thyroid cancer on the course of a pre-exisiting GO has not been specifically investigated.

The aim of this study is to assess the influence of RAI treatment administered for differentiated thyroid cancer on the course of a pre-existing GO.

This is a retrospective multicenter study including 35 patients from the University Hospital of Clermont-Ferrand (7 patients) and Lyon-Est (6 patients) in France and from a literature review published as case reports or studies (22 patients).

Seven patients exhibited a worsened pre-existing GO after total thyroidectomy followed by RAI treatment for thyroid cancer. Older men, those who initially presented with a lower clinical score of GO before RAI therapy, received higher doses of 131I especially when prepared with recombinant thyroid-stimulating hormone, and/or not prepared with glucocorticoids during RAI are at a higher risk to worsen their GO.

This study is the first and complete study collection. We describe worsening of GO in 20% of patients after RAI treatment for thyroid cancer and determine a pool of predictive factors.

No MeSH data available.


Results of factorial discriminant analysis of mixed data. (A) Patients representation showing 2 clusters: 1 with worsening GO after TTA (blue) another with improvement or worsening after TTA (red). (B) Variables representations showing one cluster with worsening GO (blue).
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Figure 2: Results of factorial discriminant analysis of mixed data. (A) Patients representation showing 2 clusters: 1 with worsening GO after TTA (blue) another with improvement or worsening after TTA (red). (B) Variables representations showing one cluster with worsening GO (blue).

Mentions: Figure 2A is the representation on a plane projection of discriminant variables (circle of correlations) and the Fig. 2B is the FDA patients’ map. The FDA defined 2 clusters of patients. The cluster of patients with deteriorated GO after RAI tended to be older men, with mild GO, prepared by RhTSH for RAI treatment and received a higher cumulative dose of RAI. The cluster of patients with improvement or stabilization of GO after RAI tended to be women with initial moderate to severe GO and higher CAS level who have received prophylactic glucocorticoids after RAI administration.


Time course of Graves ’ orbitopathy after total thyroidectomy and radioiodine therapy for thyroid cancer
Results of factorial discriminant analysis of mixed data. (A) Patients representation showing 2 clusters: 1 with worsening GO after TTA (blue) another with improvement or worsening after TTA (red). (B) Variables representations showing one cluster with worsening GO (blue).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5134772&req=5

Figure 2: Results of factorial discriminant analysis of mixed data. (A) Patients representation showing 2 clusters: 1 with worsening GO after TTA (blue) another with improvement or worsening after TTA (red). (B) Variables representations showing one cluster with worsening GO (blue).
Mentions: Figure 2A is the representation on a plane projection of discriminant variables (circle of correlations) and the Fig. 2B is the FDA patients’ map. The FDA defined 2 clusters of patients. The cluster of patients with deteriorated GO after RAI tended to be older men, with mild GO, prepared by RhTSH for RAI treatment and received a higher cumulative dose of RAI. The cluster of patients with improvement or stabilization of GO after RAI tended to be women with initial moderate to severe GO and higher CAS level who have received prophylactic glucocorticoids after RAI administration.

View Article: PubMed Central - PubMed

ABSTRACT

The risk of cancer is relatively higher in Graves’ patients presenting simultaneously with thyroid nodules. Radioiodine (RAI) therapy recommended in high-risk differentiated thyroid carcinoma may be associated with worsening of a pre-existing Graves’ orbitopathy (GO) or developing a new onset. The impact of RAI therapy in patients with differentiated thyroid cancer on the course of a pre-exisiting GO has not been specifically investigated.

The aim of this study is to assess the influence of RAI treatment administered for differentiated thyroid cancer on the course of a pre-existing GO.

This is a retrospective multicenter study including 35 patients from the University Hospital of Clermont-Ferrand (7 patients) and Lyon-Est (6 patients) in France and from a literature review published as case reports or studies (22 patients).

Seven patients exhibited a worsened pre-existing GO after total thyroidectomy followed by RAI treatment for thyroid cancer. Older men, those who initially presented with a lower clinical score of GO before RAI therapy, received higher doses of 131I especially when prepared with recombinant thyroid-stimulating hormone, and/or not prepared with glucocorticoids during RAI are at a higher risk to worsen their GO.

This study is the first and complete study collection. We describe worsening of GO in 20% of patients after RAI treatment for thyroid cancer and determine a pool of predictive factors.

No MeSH data available.