Background: There is uncertainty regarding the effective dose for radioiodine ablation. Previous studies and current guidelines contradict regarding the best fixed dose for effective ablation. We quantitatively assessed the relative efficacy and safety of 30 and 100 mCi RAI for low risk differentiated thyroid cancer (DTC).
Methods: English - language reports of Randomized Controlled trials (RCT) were identified through MEDLINE, pubmed, clinicaltrials.gov and google scholar search from year 2005 - 2015. Survey of literatures yielded 15 articles, 14 of which compared the efficacy of low dose versus high dose RAI for post-surgical ablation. In which, only 5 meet the set inclusion and exclusion criteria.
Results: In the meta-analysis of 5 published RCT trials with 1129 patients; successful thyroid remnant ablation was observed in the 100 mCi over 30 mCi RAI. Failure rate for 30 mCi was as high as 1.44 x over that of 100 mCi. The secondary outcome of lacrimal dysfunction was insignificant among the two doses, while salivary gland dysfunction was more prominent in the 100 mCi.
Conclusion: Successful ablation will reduce overall cancer recurrence and increase patient survival. Therefore, we conclude after meticulous review of the available RCT studies, 100 mCi is preferred over 30 mCi RAI for remnant ablation.