Current concepts of 131I therapy in oncology: Indications, methods and follow up

Radioiodine in various forms (as sodium iodide and as the iodinated compounds MIBG, LIPIODOL, et al.) has been used as a therapeutic agent in oncology. Differentiated thyroid carcinoma (DTC) has been successfully treated by 131I therapy. Neuroendocrine tumors can be treated by palliative therapy, including Meta 131Iodobenzylguanidine therapy (131I-MIBG). Diagnostic 131I or 123I-MIBG scintigraphy is usually performed to image neuroblastoma and malignant pheochromocytoma. Following the establishment of the diagnosis, 131I-MIBG may be applied as a therapeutic agent but with limited success. Hepatocellular carcinoma (HCC) is treated by surgery only in 10% of patients. In others, palliative therapy should be administered. Radionuclide therapy for this disease is a therapeutic option with a major advantage compared to systemic chemotherapy, estrogen and progesterone therapy, and immunotherapy. 131I-lipiodol can be used to treat HCC without side effects. Compared to untreated patients, those who received 131Ilipiodol, showed significantly better survival and a decreased recurrence rate. The modern aspect of the neoplasm treatment involves radioimmunotherapy with radioiodine and some other radionuclides. Monoclonal antibody therapy with radioiodine has been extensively succeeded in the therapy of B-cell non-Hodgkin’s lymphoma, prostate cancer. Radioimmunotherapy is also efficiently performed in some other malignancies such as: medullary thyroid carcinoma, breast cancer, colorectal cancer and malignant brain tumors. Radioimmunotherapy will play a key role in the treatment of malignant diseases, especially hematopoietic neoplasms during this millennium