Initial results of the INSPIRE clinical trial-investigating radiation dosimetry for differentiated thyroid cancer patients

Jan Taprogge; Carla Abreu; Lenka Vávrová; Lily Carnegie-Peake; Dominic Rushforth; Paul Gape; Jonathan Gear; Iain Murray; Kee H Wong; Kate Newbold; Siraj Yusuf; Glenn Flux

doi:10.3389/fnume.2023.964478

Initial results of the INSPIRE clinical trial-investigating radiation dosimetry for differentiated thyroid cancer patients

Front Nucl Med. 2023 May 15:3:964478. doi: 10.3389/fnume.2023.964478. eCollection 2023.

Authors

Jan Taprogge^{1

2}, Carla Abreu^{1

2}, Lenka Vávrová^{1

2}, Lily Carnegie-Peake^{1

2}, Dominic Rushforth^{1

2}, Paul Gape^{1

2}, Jonathan Gear^{1

2}, Iain Murray^{1

2}, Kee H Wong³, Kate Newbold³, Siraj Yusuf⁴, Glenn Flux^{1

2}

Affiliations

¹ Joint Department of Physics, Royal Marsden NHSFT, Sutton, United Kingdom.
² Radioisotope Physics, Institute of Cancer Research, London, United Kingdom.
³ Thyroid Unit, Royal Marsden NHSFT, Sutton, United Kingdom.
⁴ Department of Nuclear Medicine and PET/CT, Royal Marsden NHSFT, Sutton, United Kingdom.

Abstract

Introduction: The optimal strategy for differentiated thyroid cancer (DTC) patients treated with radioiodine (RAI) following thyroidectomy remains controversial. Multi-centre clinical studies are essential to identify strategies to improve patient outcomes while minimising treatment-induced toxicity.

Materials and methods: The INSPIRE clinical trial (ClinicalTrials.gov Identifier: NCT04391244) aims to investigate patient-specific dosimetry for DTC patients and to determine the range of absorbed doses delivered to target and non-target tissues and their relationship with treatment outcome and toxicity.

Results: We report here initial results of the first 30 patients enrolled onto the INSPIRE trial. A large range of absorbed doses are observed for both thyroid remnants and salivary glands, with median values of 4.8 Gy (Range 0.2 - 242 Gy) and 0.3 Gy (Range 0.1 to 1.7 Gy), respectively.

Discussion: The preliminary study results are encouraging and could help to improve our understanding of absorbed doses to thyroid remnants and normal organs following RAI therapy. Such knowledge could potentially enable patient-specific treatment planning with improved clinical outcomes and quality-of-life of patients.

Keywords: differentiated thyroid cancer; dosimetry; multi-centre trial; radioiodine; residual thyroid tissue.

Associated data

ClinicalTrials.gov/NCT04391244

Grants and funding

NHS funding was provided to the NIHR Biomedical Research Centre at The Royal Marsden and the ICR. The MEDIRAD project has received funding from the Euratom research and training programme 2014–2018 under grant agreement No 755523. The RTTQA group is funded by the National Institute for Health and Care Research (NIHR). We acknowledge infrastructure support from the NIHR Royal Marsden Clinical Research Facility Funding. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.