[Radiometabolic therapy in differentiated carcinoma of the thyroid gland]

The use of I131, for metabolic therapy is a procedure that has been used for many years in the treatment of thyroid carcinomas. Nevertheless, there is no agreement in the use of metabolic therapy. In fact there are therapeutic regimens that foresee the use of I131 following total or subtotal thyroidectomy even in the ablation of postsurgical thyroid residuals in patients with favourable pathological stage and there are metabolic therapeutic schemes only for advanced pathological stages. In fact, result of metabolic therapy are very significant in patients with advanced disease, whereas there is little difference between treated and non-treated patients with disease in the favourable stage, even if metabolic therapy allows a more accurate clinical follow-up. Both univariate and multivariate statistical analysis has demonstrated that neoplastic cell iodine uptake, a fundamental mechanism in metabolic therapy, is the most important prognostic factor in patients with advanced disease. The comparison with other types of treatment with respect to logistic organization or simply cost is also in favour of metabolic therapy as this requires a few days of hospitalization, at low cost and with few acute or late side-effects. On the contrary, the need for an adequately protected ward and difficulty in the dosimetry calculation in each metastasis does not favour metabolic therapy.(ABSTRACT TRUNCATED AT 250 WORDS)