Risk of Infertility in Reproductive-Age Patients With Thyroid Cancer Receiving or Not Receiving 131I Treatment: A Nationwide Population-Based Cohort Study.

IF 9.6 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Clinical Nuclear Medicine Pub Date : 2025-03-01 Epub Date: 2024-11-16 DOI:10.1097/RLU.0000000000005570
Chun-Yi Lin, Cheng-Li Lin, Chia-Hung Kao
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Abstract

Background: Fertility is the crucial concern for many survivors of cancer diagnosed as children, adolescents, and young adults. The objective of this study was to determine the risk of infertility in reproductive-age patients with thyroid cancer receiving or not receiving radioiodine treatment in Taiwan.

Methods: This nationwide population-based cohort study was conducted using data obtained from the Taiwan National Health Insurance Database from 2009 to 2019. A total of 20,259 thyroid cancer patients aged from 15 to 50 years (8037 did not receive 131I treatment, and 12,222 received 131I treatment) and 20,259 controls were enrolled. A Cox proportional hazards model was applied to estimate the risk of infertility in thyroid cancer patients receiving or not receiving 131I treatment in terms of hazard ratios and 95% confidence intervals.

Results: The incidence rates of infertility in thyroid cancer receiving 131I therapy, those not receiving 131I therapy, and controls were 5.55, 5.07, and 3.61 per 1000 person-years, respectively. Compared with thyroid cancer patients treated with a cumulative 131I dose of 4.44 GBq or less, the risk of infertility was not significantly increased in those treated with a cumulative 131I dose of more than 4.44 GBq (adjusted hazard ratio, 1.13; 95% confidence interval, 0.95-1.36).

Conclusions: The greatest increased risk of infertility in reproductive-age patients with thyroid cancer is associated with the fact that the patient has thyroid cancer regardless of 131I administration. 131I treatment or cumulative dose of 131I greater than 4.44 GBq did not further increase the risk of infertility.

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育龄甲状腺癌患者接受或未接受131 - i治疗的不孕风险:一项全国性人群队列研究
背景:生育能力是许多儿童、青少年和青年癌症幸存者最关心的问题。摘要本研究旨在探讨台湾育龄甲状腺癌患者接受或未接受放射性碘治疗的不孕风险。方法:采用台湾省国民健康保险数据库2009年至2019年的数据进行全国性人群队列研究。共纳入年龄在15 - 50岁之间的20259例甲状腺癌患者(8037例未接受131I治疗,12222例接受了131I治疗)和20259例对照。应用Cox比例风险模型以风险比和95%置信区间估计接受或未接受131I治疗的甲状腺癌患者不孕的风险。结果:接受131I治疗的甲状腺癌患者、未接受131I治疗的甲状腺癌患者和对照组的不孕发生率分别为5.55、5.07和3.61 / 1000人年。与累积131I剂量为4.44 GBq或以下的甲状腺癌患者相比,累积131I剂量大于4.44 GBq的患者不孕的风险没有显著增加(校正风险比为1.13;95%置信区间为0.95-1.36)。结论:育龄甲状腺癌患者不孕风险的最大增加与患者是否患有甲状腺癌有关,无论是否给予131I。131I治疗或131I累积剂量大于4.44 GBq不会进一步增加不孕风险。
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来源期刊
Clinical Nuclear Medicine
Clinical Nuclear Medicine 医学-核医学
CiteScore
2.90
自引率
31.10%
发文量
1113
审稿时长
2 months
期刊介绍: Clinical Nuclear Medicine is a comprehensive and current resource for professionals in the field of nuclear medicine. It caters to both generalists and specialists, offering valuable insights on how to effectively apply nuclear medicine techniques in various clinical scenarios. With a focus on timely dissemination of information, this journal covers the latest developments that impact all aspects of the specialty. Geared towards practitioners, Clinical Nuclear Medicine is the ultimate practice-oriented publication in the field of nuclear imaging. Its informative articles are complemented by numerous illustrations that demonstrate how physicians can seamlessly integrate the knowledge gained into their everyday practice.
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