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To the Editor.—
The report of Kreps et al (226:774, 1973) failed to indicate that prolonged excessive endogenous thyrotrophic stimulation for at least 7 1/2 years, due to untreated hypothyroidism, would have promoted the growth of the tumor.This is one of the reasons that we, in our series of 68 patients followed up for 15 to 23 years, with no patient developing radiation carcinomatosis, have strongly advised that after iodine 131 therapy, treatment should include maintenance doses of levothyroxine sodium controlled by serial serum thyroxine and cholesterol determinations.
Starr P. Thyroid Cancer After Iodine-131 Therapy. JAMA. 1974;227(8):940. doi:10.1001/jama.1974.03230210050017
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