Long-term effect of postoperative radioactive iodine therapy on parathyroid function in patients with differentiated thyroid cancer.

IF 2.5 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Annals of Nuclear Medicine Pub Date : 2024-11-04 DOI:10.1007/s12149-024-01996-4

Fatma Avcı Merdin, Asena Gökçay Canpolat, Demet Çorapçıoğlu, Çiğdem Soydal, Mustafa Şahin

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Abstract

Objective: The study aimed to assess the impact of postoperative radioactive iodine (RAI) therapy on parathyroid function in patients who underwent total or subtotal thyroidectomy for differentiated thyroid cancer (DTC).

Methods: Data from 150 patients treated with RAI for DTC and 76 patients with low-risk DTC not receiving RAI were retrospectively analyzed. Clinical characteristics, preoperative and 1-month postoperative biochemical parameters, and adjusted calcium, phosphorus, parathyroid hormone (PTH), and 25-hydroxyvitamin D3 (25-OH-D) levels at 3 months, 1 year, 3 years, and 5 years post-RAI (or in the low-risk group) were recorded.

Results: A total of 226 DTC patients were included in the study (80.5% female, mean age 42.7 ± 13.2 years). Total thyroidectomy was performed in 97.3% (n = 220) of patients, with central lymph node dissection (CLND) in 41.6% (n = 94). No significant preoperative differences in PTH, aCa, P, Mg, or 25-hydroxyvitamin D3 levels were observed. However, patients receiving ≥ 3.7 GBq (or 100 mCi) RAI (n = 70) had lower calcium and PTH levels at the end of the first year following RAI treatment (p = 0.048, p = 0.032). The non-RAI group showed significantly higher calcium levels at one month postoperatively (p = 0.031) and lower rates of CLND and neck dissection. No significant differences in biochemical parameters were found at the five-year follow-up, except for one patient who developed normocalcemic hyperparathyroidism after RAI.

Conclusion: High-dose RAI therapy may lead to transient decreases in calcium and PTH levels in the early post-treatment period. However, long-term parathyroid function appears to remain unaffected in DTC patients, regardless of the RAI dose administered. Nonetheless, close monitoring of calcium and PTH levels is recommended, particularly in the early post-treatment period, to promptly manage any potential transient hypoparathyroidism.

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术后放射性碘治疗对分化型甲状腺癌患者甲状旁腺功能的长期影响

研究目的该研究旨在评估因分化型甲状腺癌（DTC）而接受甲状腺全切除术或次全切除术的患者术后接受放射性碘（RAI）治疗对甲状旁腺功能的影响：对150名接受RAI治疗的DTC患者和76名未接受RAI治疗的低风险DTC患者的数据进行了回顾性分析。记录了临床特征、术前和术后1个月的生化指标，以及RAI术后3个月、1年、3年和5年（或低风险组）的调整后钙、磷、甲状旁腺激素（PTH）和25-羟维生素D3（25-OH-D）水平：研究共纳入了 226 名 DTC 患者（80.5% 为女性，平均年龄为 42.7 ± 13.2 岁）。97.3%的患者（n = 220）接受了全甲状腺切除术，41.6%的患者（n = 94）接受了中央淋巴结清扫术（CLND）。术前PTH、aCa、P、Mg或25-羟维生素D3水平无明显差异。然而，接受≥ 3.7 GBq（或 100 mCi）RAI 的患者（n = 70）在 RAI 治疗后第一年年底的钙和 PTH 水平较低（p = 0.048，p = 0.032）。非 RAI 组术后一个月的血钙水平明显较高（p = 0.031），CLND 和颈部切除率较低。除一名患者在 RAI 治疗后出现正常钙化性甲状旁腺功能亢进外，五年随访期间的生化指标未发现明显差异：结论：大剂量 RAI 治疗可能会在治疗后早期导致钙和 PTH 水平短暂下降。然而，无论RAI的剂量如何，DTC患者的甲状旁腺长期功能似乎不受影响。尽管如此，仍建议密切监测血钙和PTH水平，尤其是在治疗后早期，以便及时处理任何潜在的一过性甲状旁腺功能减退。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Nuclear Medicine 医学-核医学

CiteScore

4.90

自引率

7.70%

发文量

111

审稿时长

4-8 weeks

期刊介绍： Annals of Nuclear Medicine is an official journal of the Japanese Society of Nuclear Medicine. It develops the appropriate application of radioactive substances and stable nuclides in the field of medicine. The journal promotes the exchange of ideas and information and research in nuclear medicine and includes the medical application of radionuclides and related subjects. It presents original articles, short communications, reviews and letters to the editor.