The Impact Of Radioiodine Therapy On Quality Of Life In Patients With Differentiated Thyroid Carcinoma

OBJECTIVE:The aims of this issue were to evaluate the effect of radioiodine therapy on quality of life in patients with differentiated thyroid carcinoma (DTC) and the status of quality of life in patients compared with the general people. To analyze the impact of related factors on quality of life in patients.METHODS:A total of136patients with DTC were investigated in this study from September2012to February2013at the thyroid nuclide therapy clinics of Qilu Hospital of Shandong University. The instrument used to measure quality of life in patients was the Quality of Life Core Questionnaire of the European Organization for Research and Treatment of cancer (EORTC QLQ-C30). These patients were divided into two groups,1, patients who have undergone thyroid surgery without radioiodine therapy;2,patients who have undergone thyroid surgery and radioiodine therapy. Sex-and age-matched control group was derived from a group of health volunteers(n=138). All statistical analysis was performed by SPSS17.0software. Statistical evaluation included T-test or analysis of variance (ANOVA) or Spearman correlation.RESULT:1, The QOL of patients was changed after the initial radioiodine therapy. The changes were mainly expressed in decreased emotional function and an improved performance in dyspnea and constipation.2, The patients who have undergone thyroid surgery without radioiodine therapy reported significantly more problems than the control group independent of gender and age effects in all but four domains, namely role functioning, insomnia, constipation, diarrhea.3, The patients who have undergone thyroid surgery with radioiodine therapy reported significantly more problems than the general population in all but two domains, namely constipation and diarrhea.4, The impact factors for QOL of patients. The female patients have more problems in insomnia. The physical function of patients get worse with the increase of age. The higher the education level,the higher the social function and the economic level. Patients with different pathological stage or recurrence risk indicated different score in physical function, fatigue, appetite loss and constipation. The patients who underwent total thyroidectomy and central compartment neck dissection had a worse scores in global health status. There were no differences in QOL scores between patients who received different times of RAI. With or without the acknowledge of the disease has no effect on the QOL scores of patients.5, Correlation factor analysis showed:female gender and insomnia were positively correlated. Age and physical function were negatively correlated, but with pain, insomnia were positively correlated. Education level was negatively correlated with economic difficulties. The pathologic staging was negatively correlated with cognitive function, and positively correlated with appetite loss and constipation. The recurrence risk was positively correlated with dyspnea. The extent of surgery and global health status were negatively correlated.CONCLUSIONS:1, Although patients with DTC were expected to have disease-specific survival comparable to the general population, they experienced a significantly decreased QOL. The patients undergone surgery with or without radioiodine therapy complained more problems than general population.2, RAI was a safe and effective treatment for DTC, had no negative effect on patients’QOL. Postoperative patients with DTC after RAI complained less problems in dyspnea and constipation domain. But they experienced more problems in the emotional function. This may be related to its special treatment model, such as drugs and environment.3, Female, advanced age. lower level of education, advanced pathologic stage, the higher risk of recurrence and the extent of surgery were the negative impact factors on the QOL in patients with DTC.