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Center | Guidelines | Risk category | Dose (GBq) | Population | Protocol changes 2000–2010 |
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London,ON | ATA | Intrathyroidal disease (T1–T3, multifocal) | 3.7 | ATA guidelines | Prior to 2009: all papillary >1 cm, multifocal micropapillary with aggregated diameter ≥1 cm, all follicular, all N1 and M1 |
2009-2010; no therapy for T1 except of aggressive variants RAI doses have not changed |
N1, ETE | 5.5 |
M1 | 7.4 |
|
Halifax, NS | Local guidelines adapted from ATA | Very low risk | 1.1 | Pts with nodal disease; P T3 and P T4; Other risk factors: lymphovascular invasion, perineural invasion, aggressive variants | Prior to 2009: RAI considered for all pts except pT1 N0, young (<45) F. |
Low risk | 3.7 |
Intermediate risk with significant nodal disease | 5.5 | After 2009: more selective approach of pts selection for RAI administration; RAI doses have not changed |
High risk, distant mets, gross residual disease | 7.4 |
|
Winnipeg, MB | Local (CancerCare Manitoba) | Low risk | 1.1 | TNM (originally) | Established in 2001 |
Intermediate risk | 3.7 | Now individualized | No changes until 2014 |
High risk | 5.5 | | |
M1 | 7.4 | | |
|
Toronto, ON | ATA and local | Low risk | <1.1 | ATA guidelines | After 2005: no treatment for low risk and some moderate risk lower doses 1.1–2.8 instead of 3.7–5.5 |
Moderate risk | 1.1–2.8 |
High risk | >2.8 |
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St. John’s, NL | ATA | Not provided | N/A | Almost all patients are treated | No changes |
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Hamilton, ON | Local | Not provided | | All follicular carcinomas Papillary with nodal involvement T4 stage | Doses have been decreased gradually |
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Fredericton, NB | Toronto, ON protocol | Not provided | | All patients except those who decline or have microcarcinomas | Prior to 2012: All pts went to Radiation Oncology and Whole Body Scan-based follow-up; Stim Tg and US not done routinely |
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