The use of radioactive iodine in thyroid carcinoma

The use of radioactive iodine (131I) for the treatment of primary carcinoma of the thyroid and as an alternative to a surgical thyroidectomy in the management of patients with metastatic disease is described. The rationale for using 131I to ablate normal thyroid tissue after a surgical thyroidectomy is considered in relation to the natural history of papillary and follicular tumours and in recognition of the results of such a policy in some recently reported series. It is concluded that 131I ablation is indicated in patients with follicular tumours: and in patients with papillary tumours if they are over the age of 40 or if the tumour contains a substantial follicular component. The management of patients undergoing post-operative 131I ablation is outlined and the possible complications of such treatment which include radiation thyroiditis, radiation sialitis, transient hyperthyroidism and oedema of the neck are described.