| Ji Yanhui,Wang Xuan,Li Xue,et al.Comparison of 131I therapeutic responses and clinical outcomes in patients with familial and sporadic differentiated thyroid cancer[J].Chinese Journal of Radiological Medicine and Protection,2024,44(6):531-536 |
| Comparison of 131I therapeutic responses and clinical outcomes in patients with familial and sporadic differentiated thyroid cancer |
| Received:November 27, 2023 |
| DOI：10.3760/cma.j.cn112271-20231127-00188 |
| KeyWords:Familial differentiated thyroid carcinoma Therapeutic response 131I therapy Disease state |
| FundProject:天津医科大学总医院新世纪人才项目(2090602405);天津市卫生健康科技项目(ZC20181) |
| Author Name | Affiliation | E-mail | | Ji Yanhui | Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin 300052, China | | | Wang Xuan | Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin 300052, China | | | Li Xue | Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin 300052, China | | | Sun Danyang | Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin 300052, China | | | Xiao Qian | Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin 300052, China | | | He Yajing | Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin 300052, China | | | Meng Zhaowei | Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin 300052, China | | | Jia Qiang | Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin 300052, China | | | Tan Jian | Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin 300052, China | | | Zheng Wei | Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin 300052, China | zhengw@tmu.edu.cn |
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| Abstract:: |
| Objective To analyze the clinical outcomes of initial radioactive iodine 131I therapy (RIT) for patients with familial differentiated thyroid cancer (FDTC) and sporadic differentiated thyroid cancer (SDTC), along with their influencing factors. Methods The clinical data of 120 FDTC and 480 SDTC patients who received RIT at the Department of Nuclear Medicine, Tianjin Medical University General Hospital from January 2016 to January 2022 were retrospectively analyzed. These patients, categorized into the FDTC and SDTC groups, were further divided into three subgroups based on their response to initial RIT: no evidence of disease (NED), biochemical persistence of disease (BPD), or structural/functional persistence of disease (S/FPD). For the NED subgroup, the disease-free survival (DFS) was analyzed. For the BPD and S/FPD subgroups, the progression-free survival (PFS) was investigated. Furthermore, risk factors for failure to reach the NED status were identified. Results After initial RIT, 56 (46. 7%), 50 (41. 7%), 14 (11. 6%) patients in the FDTC group reached the NED, BPD, and S/FPD statuses, respectively, while 284 (59. 1%), 160 (33. 3%), 36 (7. 5%) and SDTC patients in the SDTC group were in the NED, BPD, and S/FPD statuses, respectively (χ2 = 10. 10, P = 0. 013). The last follow-up revealed that 71 (59. 1%), 36 (30. 1%), 13 (10. 8%) patients in the FDTC group were in the NED, BPD and S/FPD statuses, respectively, while 337 (70. 2%), 114 (23. 7%), 29 (6. 1%) patients in the SDTC group reached the NED, BPD and S/FPD statuses, respectively (χ2 = 8. 99, P = 0. 026). The F-NED and S-NED subgroups exhibited 5-year DFS rates of 92. 4% and 97. 4%, respectively, the F-BPD and S-BPD subgroups displayed 5-year PFS rates of 88. 3% and 90. 8%, respectively, while the F-S/FPD and S-S/FPD subgroups yielded in 5-year PFS rates of 78. 2% and 79. 6%, respectively. Univariate binary logistic regression analysis indicated that the maximum diameter of tumors, T stage, M stage, recurrence risk stratification, and postoperative stimulated thyroglobulin (p-sTg) were correlated with the achievement of the NED status (χ2=6. 37-13. 10, P＜0. 05). Multivariable binary logistic regression analysis showed that T stage and p-sTg were independent risk factors in the achievement of the NED status (χ2=0. 11-11. 33, P＜0. 05). Conclusions The response to initial RIT assists in guiding the development of subsequent treatment and follow-up strategies for DTC patients. Given that the SDTC patients exhibited better outcomes than the FDTC patients, more alertness should be paid to the RIT for FDTC patients. For patients with higher p-sTg and T stage, the initial RIT dose and follow-up interval should be increased and reduced respectively as appropriate. |
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