Abstract：
The 2015 American Thyroid Association (ATA) guidelines called for significantly more selective 131I therapy in patients with low-risk differentiated thyroid cancer (DTC). We hypothesized that application of these guidelines would significantly reduce the 131I activity utilized by an academic tertiary hospital in Jordan.
All DTC patients managed at Jordan University Hospital (JUH) between 1/2009 and 6/2019 were classified according to the 2015 ATA risk category and 131I activity was assigned accordingly. The actual 131I activity administered was compared with that recommended by the 2015 ATA guidelines.
In total, 135/182 DTC patients (74.2%) managed at JUH underwent 131I therapy. Of those, 58 (43%) had ATA low-, 58 (43%) intermediate-, and 19 (14%) high-risk disease. The low-, intermediate-, and high-risk DTC patients received an average (±SD) initial 131I activity of 3.53 ± 0.95, 4.40 ± 1.49, and 5.06 ± 2.52 GBq, respectively. Withholding 131I therapy altogether in the 2015 ATA low-risk patients would result in decreasing the 131I activity in the overall patient population by 37%. Withholding 131I therapy only in low-risk papillary thyroid microcarcinomas while administering 1.11 GBq of 131I to other low-risk patients would result in 28% reduction of 131I.
This study demonstrates a significant reduction in 131I therapeutic activity that would be given to DTC patients in an academic tertiary setting in Jordan, following acceptance of the 2015 ATA recommendations. Institutions that adopted the 2015 ATA guidance should measure outcomes in comparison to their historical controls and report those findings, while long-term results of randomized controlled trials are forthcoming.
All DTC patients managed at Jordan University Hospital (JUH) between 1/2009 and 6/2019 were classified according to the 2015 ATA risk category and 131I activity was assigned accordingly. The actual 131I activity administered was compared with that recommended by the 2015 ATA guidelines.
In total, 135/182 DTC patients (74.2%) managed at JUH underwent 131I therapy. Of those, 58 (43%) had ATA low-, 58 (43%) intermediate-, and 19 (14%) high-risk disease. The low-, intermediate-, and high-risk DTC patients received an average (±SD) initial 131I activity of 3.53 ± 0.95, 4.40 ± 1.49, and 5.06 ± 2.52 GBq, respectively. Withholding 131I therapy altogether in the 2015 ATA low-risk patients would result in decreasing the 131I activity in the overall patient population by 37%. Withholding 131I therapy only in low-risk papillary thyroid microcarcinomas while administering 1.11 GBq of 131I to other low-risk patients would result in 28% reduction of 131I.
This study demonstrates a significant reduction in 131I therapeutic activity that would be given to DTC patients in an academic tertiary setting in Jordan, following acceptance of the 2015 ATA recommendations. Institutions that adopted the 2015 ATA guidance should measure outcomes in comparison to their historical controls and report those findings, while long-term results of randomized controlled trials are forthcoming.
摘要：
2015年美国甲状腺协会（ATA）指南呼吁对低风险分化型甲状腺癌（DTC）患者进行更多选择性131I治疗。我们假设这些指南的应用将显着减少约旦一家三级医院使用的131I活性。
2009年1月至2019年6月在约旦大学医院（JUH）接受治疗的所有DTC患者均根据2015年ATA风险类别进行分类，并相应分配131I活动。将施用的实际131I活性与2015年ATA指南建议的活性进行比较。
总共，135/182名DTC患者（74.2%）在JUH接受131I治疗。其中,58（43%）的ATA低，58（43%）中间体-，和19（14%）高危疾病。低,中介-，高危DTC患者接受平均（±SD）131I初始活动为3.53±0.95、4.40±1.49和5.06±2.52GBq，分别。在2015年ATA低危患者中完全保留131I治疗将导致整个患者群体中131I活性降低37%。仅在低风险甲状腺乳头状微癌中保留131I治疗，而向其他低风险患者施用1.11GBq的131I将导致131I减少28％。
这项研究表明，131I治疗活性显着降低，这将给予DTC患者在约旦的学术三级设置，在接受2015年ATA建议后。采用2015年ATA指南的机构应比较其历史控制来衡量结果，并报告这些发现。而随机对照试验的长期结果即将公布.
2009年1月至2019年6月在约旦大学医院（JUH）接受治疗的所有DTC患者均根据2015年ATA风险类别进行分类，并相应分配131I活动。将施用的实际131I活性与2015年ATA指南建议的活性进行比较。
总共，135/182名DTC患者（74.2%）在JUH接受131I治疗。其中,58（43%）的ATA低，58（43%）中间体-，和19（14%）高危疾病。低,中介-，高危DTC患者接受平均（±SD）131I初始活动为3.53±0.95、4.40±1.49和5.06±2.52GBq，分别。在2015年ATA低危患者中完全保留131I治疗将导致整个患者群体中131I活性降低37%。仅在低风险甲状腺乳头状微癌中保留131I治疗，而向其他低风险患者施用1.11GBq的131I将导致131I减少28％。
这项研究表明，131I治疗活性显着降低，这将给予DTC患者在约旦的学术三级设置，在接受2015年ATA建议后。采用2015年ATA指南的机构应比较其历史控制来衡量结果，并报告这些发现。而随机对照试验的长期结果即将公布.
