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Inicio Revista Española de Medicina Nuclear e Imagen Molecular (English Edition) Update on iodine-refractory differentiated thyroid carcinoma
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Vol. 42. Issue 5.
Pages 325-334 (September - October 2023)
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Vol. 42. Issue 5.
Pages 325-334 (September - October 2023)
Special collaboration
Update on iodine-refractory differentiated thyroid carcinoma
Actualización en carcinoma diferenciado de tiroides refractario a radioyodo
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E. Abou Jokh Casasa,
Corresponding author
estephanyaboujokh@gmail.com

Corresponding author.
, A. Repettob, A. Rodriguez Gasénc, J.L. Vercher Conejeroc, P. Bello Arquesd, T. Cambil Molinae, J.A. Vallejo Casasf
a Servicio de Medicina Nuclear del Hospital Universitario Lucus Augusti, Lugo, Spain
b Servicio de Medicina Nuclear del Hospital Universitario Son Espases, Palma de Mallorca, Islas Baleares, Spain
c Servicio Medicina Nuclear del Hospital Universitario de Bellvitge, Barcelona, Spain
d Hospital La Fe de Valencia, Valencia, Spain
e Servicio de Medicina Nuclear del Hospital Universitario Virgen Marcarena, Sevilla, Spain
f Hospital Universitario Reina Sofía. IMIBIC. Universidad de Córdoba, Córdoba, Spain
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Table 1. Definitions of iodine refractoriness proposed by different authors.
Table 2. Systemic therapy supported by phase 3 clinical trials.
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Abstract

Radioiodine therapy represents a fundamental pillar in the routine adjuvant therapy of patients with high-risk differentiated thyroid carcinoma. However, a non-negligible percentage of these patients will develop iodine refractoriness, showing a worse prognosis, as well a lower survival, which demonstrates a clear need to explore different therapeutic approaches. Iodine refractory patient treatment continues to be a challenge, currently having different novel therapeutic options that should be known by the different specialties related to differentiated thyroid carcinoma (DTC). The aim of this work is to review iodine refractory thyroid carcinoma treatment, focusing especially on the definition of iodine refractoriness, highlighting its importance due to its high mortality, and introducing the different therapeutic options available for these patients.

Keywords:
Differentiated thyroid carcinoma
Iodine refractoriness
Systemic therapy
Resumen

La terapia con radioyodo constituye un pilar fundamental en la terapia adyuvante de rutina de los pacientes con carcinoma diferenciado de tiroides de alto riesgo. Sin embargo, un porcentaje no despreciable de estos pacientes desarrollaran un estado de refractariedad a este tratamiento, mostrando un peor pronóstico, disminuyendo la supervivencia y la esperanza de vida, lo que demuestra una clara necesidad de explorar distintos abordajes terapéuticos. El tratamiento de los pacientes refractarios al radioyodo sigue siendo un desafío, disponiendo en la actualidad de distintas opciones terapéuticas novedosas que deben ser conocidas por las distintas especialidades relacionadas con el carcinoma diferenciado de tiroides (CDT). El objetivo del presente trabajo es hacer una revisión del CDT refractario al tratamiento con yodo radiactivo, centrándose especialmente en la definición de yodorrefractariedad, destacando su importancia por su elevada mortalidad, e introducir las diferentes opciones terapéuticas disponibles para estos pacientes.

Palabras clave:
Carcinoma diferenciado de tiroides
Yodorrefractariedad
Terapia sistémica

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