What is your approach to treat metastatic poorly differentiated thyroid cancer with papillary features?

The easy answer is that there is a role for I-131 if the remnant disease (tumor bed or mets) is iodine avid.

Harder and perhaps more realistic is that the test dose of 2-3 mCi is too low and you have to overwhelm the iodine receptor with at least 30 mCi to activate a radiologic response.

If you are concerned about blood or bone marrow toxicity, discuss body dosimetry with your nuclear medicine department (they all use a different formula to measure) and if the OAR dose is low enough, most would ...