NEJM: Effect of radioactive iodine therapy without radioactive iodine after thyroidectomy in patients with low-risk thyroid cancer

In patients with low-risk differentiated thyroid cancer undergoing thyroidectomy, postoperative use of radioactive iodine (iodine-131) is controversial because of no apparent benefit

In this prospective, randomized, phase 3 trial, researchers assigned patients with low-risk differentiated thyroid cancer undergoing thyroidectomy to receive ablation therapy followed by postoperative injections, according to a study published in the top medical journal NEJM.

The primary objective of the study was to assess whether radioactive iodine-free therapy was noninferior to radioactive iodine therapy in the absence of a composite endpoint of 3-year functional, structural, and biological abnormalities

Among the 730 patients evaluable at 3 years after randomization, the percentage of patients who were event-free was 95.

CONCLUSIONS: In low-risk thyroid cancer patients undergoing thyroidectomy, a follow-up strategy without radioactive iodine was noninferior to a radioactive iodine ablation strategy in terms of rates of functional, structural, and biological events at 3 years