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Figure 4. A 12 year old girl who presented with papillary carcinoma with lymph node and diffuse pulmonary metastases. Her presenting pO2 was 50. Several RAI treatments were given along with steroids to minimize pulmonary fibrosis. This ablated the lymph node but did not change the lung uptake. She died of cardiopulmonary failure 10 years later.

Figure 4. A 12 year old girl who presented with papillary carcinoma with lymph node and diffuse pulmonary metastases. Her presenting pO2 was 50. Several RAI treatments were given along with steroids to minimize pulmonary fibrosis. This ablated the lymph node but did not change the lung uptake. She died of cardiopulmonary failure 10 years later.

including the United States and Canada, there is no longer a rigid requirement to admit patients for large dose therapies.

Most thyroid cancer patients do not require supportive hospital care. If they are admitted, it is because they do not have the domestic facilities necessary for self-sequestration at home, that they have come for treatment from a distance or with public transportation, or that they are considered to be unlikely to follow instructions. If these patients were treated as out-patients, they would constitute a source of radiation exposure to members of the public or to juvenile or pregnant family members. Thus, some patients are still best treated in hospital. For others, out-

Figure 5. A 62 year old woman who presented with a pathological fracture secondary to metastatic follicular carcinoma. Her hemoglobin was 80g/ L and platelets <100x109/L. With RAI therapy her disease regressed and bone marrow function normalized but the bone metastases were never ablated. She remained active for most of the next 14 years, requiring repeated RAI

treatments and occasional external beam treatments when she developed non-iodine-avid metastases.

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