María de las Nieves Sicilia Pozo , Francisco José Pena Pardo , Mariano Amo Salas , Marcos Cruz Montijano , Javier Torres Hernández , Amanda Padilla Bermejo , Cristina Montalbán Méndez , María Zhao Montero , Ángel Soriano Castrejón , Ana María García Vicente
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They were categorised based on the American Thyroid Association (ATA) classification of response to initial therapy.</p><p>Patients were reclassified in the following 6–18 months after second RAIT based on imaging findings and measurements of thyroglobulin and antithyroglobulin antibody levels.</p><p>The associations of a downgrading of response category and progression-free survival (PFS), and the related variables, were evaluated.</p></div><div><h3>Results</h3><p>Sixty-six patients (55%) had a downgrading on ATA response category after second RAIT. A significant interdependence of causes for second RAIT and outcomes was found (<em>χ</em><sup>2</sup> <!-->=<!--> <!-->29.400, <em>p</em> <!-->=<!--> <!-->0.001), with patients with neck reoperation showing a higher rate of indeterminate or excellent responses.</p><p>A significant association between ATA response to second RAIT and absence of structural progression was found (<em>χ</em><sup>2</sup> <!-->=<!--> <!-->44.914, <em>p</em> <!--><<!--> <!-->0.001), with less structural progression in patients with downgrading on ATA response (<em>χ</em><sup>2</sup> <!-->=<!--> <!-->30.914, <em>p</em> <!--><<!--> <!-->0.001). There was also significant interdependence to some clinical variables, such as AJCC stage (<em>χ</em><sup>2</sup> <!-->=<!--> <!-->8.460, <em>p</em> <!-->=<!--> <!-->0.015), ATA risk classification (<em>χ</em><sup>2</sup> <!-->=<!--> <!-->10.694, <em>p</em> <!-->=<!--> <!-->0.005) and initial N stage (<em>χ</em><sup>2</sup> <!-->=<!--> <!-->8.485, <em>p</em> <!-->=<!--> <!-->0.004).</p></div><div><h3>Conclusions</h3><p>In selected cases, a second RAIT could lead to more robust responses with a potential improvement in prognosis in patients with incomplete response to initial DTC treatment.</p></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"71 1","pages":"Pages 4-11"},"PeriodicalIF":1.8000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Second radioiodine treatment in patients with differentiated thyroid carcinoma: Causes and effects\",\"authors\":\"María de las Nieves Sicilia Pozo , Francisco José Pena Pardo , Mariano Amo Salas , Marcos Cruz Montijano , Javier Torres Hernández , Amanda Padilla Bermejo , Cristina Montalbán Méndez , María Zhao Montero , Ángel Soriano Castrejón , Ana María García Vicente\",\"doi\":\"10.1016/j.endien.2024.02.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><p>Patients with incomplete response to initial therapy of thyroid cancer can be managed with ongoing observation or potentially additional therapies.</p><p>Our aim was to assess the effect of a second radioactive iodine treatment (RAIT) and its relationship with causes and clinical variables.</p></div><div><h3>Material and methods</h3><p>Patients undergoing a second RAIT for biochemical or structural incomplete response to initial therapy of DTC were retrospectively included (<em>n</em> <!-->=<!--> <!-->120). They were categorised based on the American Thyroid Association (ATA) classification of response to initial therapy.</p><p>Patients were reclassified in the following 6–18 months after second RAIT based on imaging findings and measurements of thyroglobulin and antithyroglobulin antibody levels.</p><p>The associations of a downgrading of response category and progression-free survival (PFS), and the related variables, were evaluated.</p></div><div><h3>Results</h3><p>Sixty-six patients (55%) had a downgrading on ATA response category after second RAIT. A significant interdependence of causes for second RAIT and outcomes was found (<em>χ</em><sup>2</sup> <!-->=<!--> <!-->29.400, <em>p</em> <!-->=<!--> <!-->0.001), with patients with neck reoperation showing a higher rate of indeterminate or excellent responses.</p><p>A significant association between ATA response to second RAIT and absence of structural progression was found (<em>χ</em><sup>2</sup> <!-->=<!--> <!-->44.914, <em>p</em> <!--><<!--> <!-->0.001), with less structural progression in patients with downgrading on ATA response (<em>χ</em><sup>2</sup> <!-->=<!--> <!-->30.914, <em>p</em> <!--><<!--> <!-->0.001). There was also significant interdependence to some clinical variables, such as AJCC stage (<em>χ</em><sup>2</sup> <!-->=<!--> <!-->8.460, <em>p</em> <!-->=<!--> <!-->0.015), ATA risk classification (<em>χ</em><sup>2</sup> <!-->=<!--> <!-->10.694, <em>p</em> <!-->=<!--> <!-->0.005) and initial N stage (<em>χ</em><sup>2</sup> <!-->=<!--> <!-->8.485, <em>p</em> <!-->=<!--> <!-->0.004).</p></div><div><h3>Conclusions</h3><p>In selected cases, a second RAIT could lead to more robust responses with a potential improvement in prognosis in patients with incomplete response to initial DTC treatment.</p></div>\",\"PeriodicalId\":48650,\"journal\":{\"name\":\"Endocrinologia Diabetes Y Nutricion\",\"volume\":\"71 1\",\"pages\":\"Pages 4-11\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2024-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Endocrinologia Diabetes Y Nutricion\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2530018024000064\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Endocrinologia Diabetes Y Nutricion","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2530018024000064","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
Second radioiodine treatment in patients with differentiated thyroid carcinoma: Causes and effects
Introduction
Patients with incomplete response to initial therapy of thyroid cancer can be managed with ongoing observation or potentially additional therapies.
Our aim was to assess the effect of a second radioactive iodine treatment (RAIT) and its relationship with causes and clinical variables.
Material and methods
Patients undergoing a second RAIT for biochemical or structural incomplete response to initial therapy of DTC were retrospectively included (n = 120). They were categorised based on the American Thyroid Association (ATA) classification of response to initial therapy.
Patients were reclassified in the following 6–18 months after second RAIT based on imaging findings and measurements of thyroglobulin and antithyroglobulin antibody levels.
The associations of a downgrading of response category and progression-free survival (PFS), and the related variables, were evaluated.
Results
Sixty-six patients (55%) had a downgrading on ATA response category after second RAIT. A significant interdependence of causes for second RAIT and outcomes was found (χ2 = 29.400, p = 0.001), with patients with neck reoperation showing a higher rate of indeterminate or excellent responses.
A significant association between ATA response to second RAIT and absence of structural progression was found (χ2 = 44.914, p < 0.001), with less structural progression in patients with downgrading on ATA response (χ2 = 30.914, p < 0.001). There was also significant interdependence to some clinical variables, such as AJCC stage (χ2 = 8.460, p = 0.015), ATA risk classification (χ2 = 10.694, p = 0.005) and initial N stage (χ2 = 8.485, p = 0.004).
Conclusions
In selected cases, a second RAIT could lead to more robust responses with a potential improvement in prognosis in patients with incomplete response to initial DTC treatment.
期刊介绍：
Endocrinología, Diabetes y Nutrición is the official journal of the Spanish Society of Endocrinology and Nutrition (Sociedad Española de Endocrinología y Nutrición, SEEN) and the Spanish Society of Diabetes (Sociedad Española de Diabetes, SED), and was founded in 1954.
The aim of the journal is to improve knowledge and be a useful tool in practice for clinical and laboratory specialists, trainee physicians, researchers, and nurses interested in endocrinology, diabetes, nutrition and related disciplines.
It is an international journal published in Spanish (print and online) and English (online), covering different fields of endocrinology and metabolism, including diabetes, obesity, and nutrition disorders, as well as the most relevant research produced mainly in Spanish language territories.
The quality of the contents is ensured by a prestigious national and international board, and by a selected panel of specialists involved in a rigorous peer review. The result is that only manuscripts containing high quality research and with utmost interest for clinicians and professionals related in the field are published.
The Journal publishes Original clinical and research articles, Reviews, Special articles, Clinical Guidelines, Position Statements from both societies and Letters to the editor.
Endocrinología, Diabetes y Nutrición can be found at Science Citation Index Expanded, Medline/PubMed and SCOPUS.
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