Radioiodine therapy for differentiated thyroid carcinoma: methods used to increase the radiation absorbed dose

Our aim was to analyze measures taken to increase the radiation absorbed dose (DOSE) during treatment of well-differentiated thyroid cancer (DTC) with iodine-131. An increase in DOSE is achieved by: avoiding competition with non-radioactive iodine, stimulating cellular uptake/retention, increasing the administered activity. Basis and results of each one of these methods were reviewed. Although it is difficult to demonstrate an increase in survival, there is a direct relation between DOSE and tumoral response in DTC. Different approaches can be used aiming an increase in DOSE, with a possible improvement in tumoral response for treatment with iodine-131. Although DTC is a relatively benign disease, a better response to treatment is highly desirable in high-risk patients, who have few other options of therapy. An increase in DOSE during treatment of DTC can be achieved using the described interventions, which should be used in high-risk cases of DTC.