[131 iodine for the initial treatment of thyroid cancer]

Retrospective studies justified the use of 131 iodine after surgery in the management of thyroid cancer for reducing recurrences and improving survival. Indications based on the evaluation of prognostic factors and on the quality of surgical excision are more advisable than systematic administration, particularly in small, non aggressive tumors which are diagnosed more and more frequently. A high level of endogenous TSH and absence of iodine overload are required. Standardized fixed ablative doses reach a high rate of success. Various scintigraphic procedures allow precise localization of residual or distant uptake. Radioprotection measures must be carefully applied to the patients and their environment by a skillful personnel. Side effects are rare after one ablation dose but must be systematically noted and treated. Genetic and carcinogenetic risks are very low.