Parameters Influencing The Curative Effect Of ¹³¹I Therapy On Pediatric Differentiated Thyroid Carcinoma

BackgroundThis study aimed to investigate the parameters influencing the effectiveness of first ¹³¹I thyroid remnant ablation and then ¹³¹I treatment of metastatic lesions in children and adolescents with differentiated thyroid carcinoma（DTC）.Material and MethodsA total of 88 children and adolescents with DTC were divided into two groups: 56 in the complete-ablation group and 32 in the incomplete-ablation group for the first ¹³¹I ablation; 32 in the incomplete-ablation group were further divided: 19 in the complete-remission group and 13 in the incomplete-remission group for subsequent ¹³¹I treatment of metastatic lesions. Influential parameters were analyzed using t test, t` test, rank-sum test, χ2-test, and Fisher exact test, and logistic regression analysis was performed.ResultsRadioactive iodine uptake（RAIU）, lymph node metastases, and pulmonary metastases were selected as influential parameters. After logistic regression analysis, RAIU, only lymph node metastases, and pulmonary metastasis were significantly associated with the complete-ablation rate. High levels of RAIU and serum thyroglobulin（Tg） were not conducive to disease remission after underwent subsequent ¹³¹I treatment of metastatic lesions. The remission rate of patients with pulmonary metastasis was lower than the rate of patients with lymph node metastases or no metastases.ConclusionResults demonstrated high remission rate is associated with low postoperative RAIU and Tg. Lymph node metastasis and pulmonary metastasis would reduce the complete-remission rate of first ¹³¹I ablation therapy. Pulmonary metastasis would reduce the remission rate of subsequent ¹³¹I treatment. Also, ¹³¹I treatment for pediatric DTC with pulmonary metastasis could achieve progression-free survival.