Treatment with tyrosine kinase inhibitors in patients with metastatic differentiated thyroid cancer refractory to radioiodine therapy
Solodiannykova O.I., Danylenko V.V.
Summary. The aim of the study was to develop and implement a method for treating iodine-negative metastases of differentiated thyroid cancer (DTC). Materials and methods. Thirty-eight patients with iodine-negative DTC metastases were treated, of whom 10 were evaluated for treatment efficacy using Technetium-99m sestamibi (MIBI) (99mTc-MIBI) SPECT; 10 were evaluated using Technetium-99m-dimercaptosuccinic acid (99mTc-DMCA); and in 10 patients, the immediate results of treatment with tyrosine kinase inhibitors were assessed using Positron emission tomography (PET) with 18F-fluorodeoxyglucose (18F-FDG); the group in which, in the presence of bone lesions, treatment was carried out using radionuclide and remote radiation therapy consisted of 8 patients. Results. Conducting studies to obtain metabolic images in patients with iodine-negative PTC before and after targeted therapy allowed us to evaluate its effectiveness in terms of both the size of the metastatic focus and its functional activity. Conclusions. The results of the possibilities of radionuclide diagnostic methods for assessing the effectiveness of treatment of metastases of iodine-negative thyroid cancer are presented. The capabilities of 99mTc-MIBI, 99mTc-DMCA and 18F-FDG radiopharmaceuticals were assessed using the criteria of informativeness. The indicators of statistical analysis of the effectiveness of thyroid gland treatment with tyrosine kinase inhibitors were determined. The percentage of the highest sensitivity of the used radiopharmaceuticals was established.
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