Bone metastases from differentiated thyroid carcinoma: heterogenous tumor response to radioactive Iodine therapy and overall survival.

Abstract

PURPOSE:

Bone metastases (BM) from differentiated thyroid carcinoma (DTC) impact negatively the quality of life and the life expectancy of patients. The aim of the study was (a) to evaluate the overall survival (OS) and prognostic factors of OS and (b) to assess predictive factors of complete BM response (C-BM-R) using radioiodine treatment (RAI) either alone or in association with focal treatment modalities.

METHODS:

A total of 178 consecutive DTC patients harbouring BM, treated between 1989 and 2015, were enrolled in this retrospective study conducted in two tertiary referral centers. OS analysis was performed for the whole cohort, and only the 145 considered non-RAI refractory patients at BM diagnosis were evaluated for C-BM-R following RAI.

RESULTS:

The median OS from BM diagnosis was 57 months (IQR: 24-93). In multivariate analysis, OS was significantly reduced in the case of T4 stage, 18FDG uptake by the BM and RAI refractory status. Among the 145 DTC considered non-RAI refractory patients at BM diagnosis, 46 patients (31.7%) achieved a C-BM-R following RAI treatment, either alone in 32 (18%) patients or in association with focal BM treatment modalities in 14. The absence of extra-skeletal distant metastasis and of 18FDG uptake in BM were predictive for C-BM-R.

CONCLUSIONS:

In nearly one-third of DTC patients with RAI avid BM, RAI alone or in combination with BM focal treatment can induce C-BM-R. The presence of 18FDG uptake in BM is associated with an absence of C-BM-R and with a poor OS. 18FDG PET-CT should be performed when BM is suspected.

• Authors: Arnaud Jannin, Livia Lamartina, Coralie Moutarde, Mehdi Djennaoui, George Lion, Benjamin Chevalier, Marie Christine Vantyghem, Frédéric Deschamps, Julien Hadoux, Eric Baudin, Martin Schlumberger, Sophie Leboulleux, Christine Do Cao
• Journal: European journal of nuclear medicine and molecular imaging (Eur J Nucl Med Mol Imaging) Vol. 49 Issue 7 Pg. 2401-2413 (06 2022) ISSN: 1619-7089 [Electronic] Germany
• PMID: 35149914 (Publication Type: Journal Article)
• Copyright: © 2022. The Author(s).

Chemical References

• Iodine Radioisotopes
• Fluorodeoxyglucose F18

Topics

• Adenocarcinoma
• Bone Neoplasms (diagnostic imaging, radiotherapy, secondary)
• Fluorodeoxyglucose F18
• Humans
• Iodine Radioisotopes (therapeutic use)
• Positron Emission Tomography Computed Tomography
• Quality of Life
• Retrospective Studies
• Thyroid Neoplasms (pathology)