Analysis of delayed initial radioactive iodine therapy and clinical outcomes in papillary thyroid cancer: a two-center retrospective study.

IF 1.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Nuclear Medicine Communications Pub Date : 2024-09-01 Epub Date: 2024-06-04 DOI:10.1097/MNM.0000000000001869
Tao He, Ming Li, Zheng-Lian Gao, Xiang-Yu Li, Hai-Rong Zhong, Cui-Shuang Ding, Hua-Wei Cai
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Abstract

Background: It remains unclear whether the time interval between total thyroidectomy and radioactive iodine (RAI) therapy influences clinical outcomes in papillary thyroid carcinoma (PTC). This study aims to evaluate the impact of the timing to initiate RAI therapy on the response in PTC patients.

Methods: We retrospectively included 405 patients who underwent total thyroidectomy and subsequent RAI therapy at two tertiary hospitals in southwest China. Patients were categorized into two groups based on the interval between thyroidectomy and initial RAI therapy, that is, an early group (interval ≤90 days, n  = 317) and a delayed group (interval >90 days, n  = 88). Responses to RAI therapy were classified as excellent, indeterminate, biochemical incomplete, or structural incomplete. Univariate and multivariate analyses were conducted to identify factors associated with a nonexcellent response.

Results: Excellent responses were observed in 77.3% of the early group and 83.0% of the delayed group ( P  = 0.252). No significant impact of RAI therapy timing was also observed across all American Thyroid Association risk classification categories. These findings persisted when patients were analyzed separately according to RAI dose (intermediate-dose group: 3.7 GBq [ n  = 332]; high-activity group: ≥5.5 GBq [ n  = 73]), further subdivided by the timing of RAI therapy. Multivariate analysis identified lymph node dissection, RAI dose, and stimulated thyroglobulin as independent risk factors for excellent response ( P  < 0.05).

Conclusion: The timing of initial RAI therapy following surgery did not significantly affect outcomes in patients with PTC.

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甲状腺乳头状癌延迟初始放射性碘治疗和临床结果分析:一项双中心回顾性研究。
背景:甲状腺全切除术与放射性碘(RAI)治疗之间的时间间隔是否会影响甲状腺乳头状癌(PTC)的临床预后,目前仍不清楚。本研究旨在评估开始 RAI 治疗的时间对 PTC 患者反应的影响:我们回顾性地纳入了在中国西南地区两家三甲医院接受甲状腺全切除术并随后接受RAI治疗的405例患者。根据甲状腺切除术与初次 RAI 治疗之间的间隔时间,将患者分为两组,即早期组(间隔时间≤90 天,n = 317)和延迟组(间隔时间大于 90 天,n = 88)。对 RAI 治疗的反应分为优秀、不确定、生化不完全或结构不完全。进行单变量和多变量分析以确定与非优良反应相关的因素:77.3%的早期组和83.0%的延迟组观察到了极佳反应(P = 0.252)。在美国甲状腺协会的所有风险分类类别中,也未观察到 RAI 治疗时机的重大影响。当根据 RAI 剂量对患者进行单独分析时,上述结果依然存在(中等剂量组:3.7 GBq [n = 0.2523.7 GBq [n = 332];高活性组:≥5.5 GBq [n = 73]),并根据 RAI 治疗时机进一步细分。多变量分析表明,淋巴结清扫、RAI剂量和刺激甲状腺球蛋白是获得极佳反应的独立风险因素(P 结论:RAI治疗后的初始RAI治疗时间是获得极佳反应的独立风险因素:手术后初始 RAI 治疗的时机对 PTC 患者的预后没有明显影响。
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来源期刊
CiteScore
2.20
自引率
6.70%
发文量
212
审稿时长
3-8 weeks
期刊介绍: Nuclear Medicine Communications, the official journal of the British Nuclear Medicine Society, is a rapid communications journal covering nuclear medicine and molecular imaging with radionuclides, and the basic supporting sciences. As well as clinical research and commentary, manuscripts describing research on preclinical and basic sciences (radiochemistry, radiopharmacy, radiobiology, radiopharmacology, medical physics, computing and engineering, and technical and nursing professions involved in delivering nuclear medicine services) are welcomed, as the journal is intended to be of interest internationally to all members of the many medical and non-medical disciplines involved in nuclear medicine. In addition to papers reporting original studies, frankly written editorials and topical reviews are a regular feature of the journal.
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