Radioiodine Ablation Therapy Feasible in Hemodialysis-Dependent ESKD Patients with Low-Risk Thyroid Cancer: Case Series
Australia: In a recently published case series inBMC Nephrology, researchers from the University of Sydney, led by Dr. Raymond Lin, have demonstrated that with tailored protocols and safety precautions, radioiodine (I-131) therapy can be safely administered to patients with end-stage kidney disease (ESKD) on haemodialysis (HD) who are being treated for thyroid cancer. Radioiodine therapy is a well-established adjuvant treatment for differentiated thyroid cancer (DTC), particularly following thyroidectomy. However, its use in patients with impaired renal function poses a significant challenge. In those with ESKD, the clearance of I-131 is severely reduced, increasing the risk of prolonged radiation exposure and myelotoxicity. Currently, there is no universally accepted protocol for administering radioiodine in patients on dialysis, making treatment planning complex. To address this, Dr. Lin and colleagues reported on two ESKD patients undergoing chronic haemodialysis who received I-131 therapy for low-risk thyroid cancer. The team adapted its institutional approach by implementing modifications to infrastructure, scheduling, and radiation safety protocols. This included pre-treatment patient training, altered dialysis timing, and close monitoring of serum radioactivity to ensure patient and staff safety.
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