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What factors aside from progression do you consider most important in determining whether a patient with metastatic papillary thyroid carcinoma is radioactive iodine refractory?
What is your evaluation approach for RAI response? What cumulative dose do you use in practice for deciding a patient is RAI refractory?
Answer from: at Community Practice
RAI refractory or resistant is defined as:
Progression despite adequate RAI RX within the prior year after therapy
Tumor that does not take up RAI either on a diagnostic or post-therapy whole body scan
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Answer from: at Community Practice
If thyroglobulin is up and WBS is negative and positive LN on US, then the patient might be RAI-resistant.
Answer from: at Community Practice
I consider the following:
Progression within 6-12 months of RAI
Known disease without RAI avidity on appropriately stimulated I 123 or I 131 scan
Cumulative dose over 500 mci with documented progression
Several mutations/cytological subtypes, etc., are more likely to be non-RAI avid, includi...