Jinmiao Wang, Jie Hao, Ying Gao, Shoujun Wang, Duowei Wang, Weijie Tao, Ran Duan, Zhendong Zhang, Ming Gao
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引用次数: 0
Abstract
Introduction: This study aimed to evaluate the clinical value of iodine-131 combined with levothyroxine sodium in the treatment of patients with differentiated thyroid cancer (DTC) after surgery.
Methods: Prospective randomized controlled studies were conducted. A total of 374 DTC patients who underwent total or near-total thyroidectomy in the Department of Thyroid Surgery, Tianjin Union Medical Center and Tianjin Medical University General Hospital, from January 2019 to February 2022 were selected and divided into control group (187 cases) and observation group (187 cases) according to random number table method. The control group was treated with levothyroxine sodium after surgery, and the observation group was treated with iodine-131 on the basis of the control group. Gender, age, course of disease, tumor diameter, pathological type, TNM classification, treatment effect, thyroglobulin (Tg) levels before and after treatment, SF-36 health status questionnaires (SF-36), occurrence of adverse reactions after treatment, and recurrence rate of 1-year follow-up were compared and analyzed between the two groups.
Results: There was no significant difference in baseline data between the two groups. After treatment, the effective rate of the observation group increased by 11.23% compared to the control group, with a statistically significant difference (91.98% vs. 80.75%, p < 0.05). There was no significant difference in Tg level and scores of SF-36 evaluation including physical functioning, physical problems, vitality, pain, mental health, emotional problems, social functioning, and general health perception between the two groups before surgery (p > 0.05), Tg levels and scores of SF-36 evaluation in all dimensions were significantly improved in both groups after treatment (p < 0.05), and the levels of Tg and scores of SF-36 in all dimensions in observation group were significantly better than those in control group after treatment (p < 0.001). There was no significant difference in the incidence of adverse reactions between the two groups (p > 0.05). The recurrence rate in the observation group was 5.89% lower than that in the control group 1 year after treatment, with a statistically significant difference (2.67% vs. 8.56%, p < 0.05).
Conclusions: The combination of iodine-131 and levothyroxine sodium in the postoperative treatment of DTC can improve the therapeutic effect and reduce the postoperative recurrence rate without increasing adverse reactions, which is worthy of clinical reference and promotion.
简介本研究旨在评估碘 131 联合左甲状腺素钠治疗术后分化型甲状腺癌（DTC）患者的临床价值：方法：进行前瞻性随机对照研究。选取2019年1月至2022年2月在天津协和医院、天津医科大学总医院甲状腺外科行甲状腺全切或近全切术的DTC患者共374例，按随机数字表法分为对照组（187例）和观察组（187例）。对照组术后使用左甲状腺素钠治疗，观察组在对照组基础上使用碘-131治疗。比较分析两组患者的性别、年龄、病程、肿瘤直径、病理类型、TNM分型、治疗效果、治疗前后甲状腺球蛋白（Tg）水平、SF-36健康状况问卷（SF-36）、治疗后不良反应发生情况以及随访一年的复发率：结果：两组基线数据无明显差异。治疗后，观察组有效率比对照组提高了 11.23%，差异有统计学意义（91.98% vs. 80.75%，P<0.05）。两组患者术前Tg水平及SF-36评价包括身体功能、身体问题、活力、疼痛、心理健康、情绪问题、社会功能、一般健康知觉的评分无明显差异（P>0.05），治疗后两组患者Tg水平及SF-36评价各维度评分均有明显改善（P<0.05），且治疗后观察组Tg水平及SF-36各维度评分均明显优于对照组（P<0.001）。两组不良反应发生率无明显差异（P>0.05）。治疗一年后，观察组的复发率比对照组低 5.89%，差异有统计学意义（2.67% vs. 8.56%，P<0.05）：碘131与左甲状腺素钠联合应用于分化型甲状腺癌术后治疗，可提高疗效，降低术后复发率，且不增加不良反应，值得临床借鉴与推广。
期刊介绍：
Although laboratory and clinical cancer research need to be closely linked, observations at the basic level often remain removed from medical applications. This journal works to accelerate the translation of experimental results into the clinic, and back again into the laboratory for further investigation. The fundamental purpose of this effort is to advance clinically-relevant knowledge of cancer, and improve the outcome of prevention, diagnosis and treatment of malignant disease. The journal publishes significant clinical studies from cancer programs around the world, along with important translational laboratory findings, mini-reviews (invited and submitted) and in-depth discussions of evolving and controversial topics in the oncology arena. A unique feature of the journal is a new section which focuses on rapid peer-review and subsequent publication of short reports of phase 1 and phase 2 clinical cancer trials, with a goal of insuring that high-quality clinical cancer research quickly enters the public domain, regardless of the trial’s ultimate conclusions regarding efficacy or toxicity.
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