An update on management of differentiated thyroid carcinoma

While some may still favor lobectomy, most experts recommend total thyroidectomy for DTC followed by radioablation of thyroid remnant with 131I. After such a treatment, serum Tg level serves as a useful marker of metastases of DTC. Radioiodine (131I) is a reasonable good treatment for small (mg in weight) deposits of metastases. However, large lesions, and those in the lungs and bones, do not respond well to clinically "safe" doses of 131I. Some experts suggest that employment of radiation dose based approach to 131I may improve the outcome of treatment of DTC. Agents that enhance the sensitivity of the tissues to radiation effects of 131I should be helpful and research needs to be encouraged in that area.