Dados do Resumo

Título

Efficacy of Radionuclide Therapy in Thyroid Cancer Treatment: A Critical Review of Advances and Challenges

Introdução

In medicine, therapeutic options for oncological treatment are gradually being refined. Consequently, thyroid cancer, epidemiologically the most common tumor in the head and neck region, now benefits from progressively advanced treatment methods. Therapies involving radionuclides fall into this context due to their chemical properties that emit ionizing radiation, which is used to destroy cancer cells, making them an important therapeutic option in the treatment of thyroid cancer.

Objetivo

This work aims to present a review of the effectiveness of radionuclide therapy, particularly those containing iodine, for the treatment of thyroid cancer, and to define their indications and contraindications.

Métodos

A systematic review of the scientific literature was conducted using articles published on the PubMed platform from 2023 to 2024. The keywords used were “therapeutics,” “radioisotopes,” and “thyroid neoplasms,” along with their English counterparts. A total of 226 results were found across all databases, and after reviewing titles and abstracts, 19 articles meeting the initial criteria were selected for full reading.

Resultados

Radioiodine therapy (RAI) demonstrated a significantly higher treatment response rate (94%) compared to radiofrequency (RF) ablation (59%). Additionally, anatomical factors of the thyroid, such as gland weight, tumor size, and thyroiditis, must be considered as they affect the correlation between therapy and expected outcomes. Research also assessed I-131 uptake and retention in the remaining thyroid gland, correlating it with serum off-Tg levels, thyroiditis, and ablation success in thyroid cancer patients receiving I-131 therapy. Some meta-analyses did not establish conclusive benefits of RAI in preventing structural disease recurrence or improving recurrence-free survival in intermediate-risk patients. These results should be interpreted with caution due to the significant heterogeneity in the existing literature.

Conclusões

Radionuclide therapy, particularly the use of radioiodine (RAI), has proven effective in treating thyroid cancer, with a notable response rate. However, the effectiveness of treatment may vary based on anatomical and biological factors of the thyroid. Despite observed benefits, the heterogeneity among studies suggests that further research is needed to better understand the indications, contraindications, and long-term efficacy of RAI therapy in different patient groups.

Palavras Chave

Thyroid Neoplasms; therapeutics; radioisotopes