1. BRAF V600E mutation in papillary thyroid cancer and its effect on postoperative radioiodine ( 131 I) therapy: Should we modify our therapeutic strategy?
- Author
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Domínguez Ayala M, Expósito Rodríguez A, Bilbao González A, Mínguez Gabiña P, Gutiérrez Rodríguez T, Rodeño Ortiz de Zarate E, García Carrillo M, and Barrios Treviño B
- Subjects
- Cohort Studies, Combined Modality Therapy, Female, Humans, Male, Middle Aged, Postoperative Care, Prospective Studies, Iodine Radioisotopes therapeutic use, Mutation, Proto-Oncogene Proteins B-raf genetics, Thyroid Cancer, Papillary genetics, Thyroid Cancer, Papillary therapy
- Abstract
Introduction: The BRAF V600E mutation in papillary thyroid cancer (PTC) has been associated with resistance to
131 I. Our aim was to quantify the response to131 I after surgery in patients who had the mutation (BRAF+) and those who did not have the mutated gene (BRAF-)., Method: A prospective cohort study was designed, from September 2015 to February 2016, which included patients with PTC receiving therapy after surgical treatment. Variables were described for age, gender, histology, tumor stage, thyroglobulin values before, 48h after and 6months after131 I; absorbed dose and % activity on days 2 and 7 and elimination time., Results: 41 patients giving in total 67 thyroid remnants were included. 61% were BRAF+. In stagesiii and iv, 80% were BRAF+. In lateral resection, 100% were BRAF+. The number of nodes was higher in BRAF+: 3.4 vs 1.2 (P=.01). The classic variant was predominant in BRAF+ (91.7% vs 8.3%, P=.03). 85.7% vs 14.3% of BRAF+ had desmoplastic reaction (P=.02). The BRAF+ had a lower absorbed dose than the administered activity (5.4Gy/MBq vs 20Gy/MBq, P=.02); lower% activity with respect to the unit of mass at 2 (0.046%/g vs 0.103%/g, P=.02) and at 7days (0.006%/gr vs 0.034%/gr, P=.04) CONCLUSIONS: The mutation of the BRAF V600E gene is related with greater resistance to postoperative treatment with131 I since the onset of the disease., (Copyright © 2018 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.)- Published
- 2018
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