Impact Of I-131 Treatment On Health-related Quality Of Life In Patients With Papillary Thyroid Cancer

Purpose:To analyze the health related quality of life（HRQOL）in patients with thyroid papillary carcinoma（PTC）and the effect of I-131 treatment on HRQOL in patients with PTC.Method:Three hundred and fifty-six female PTC patients with PT₁N1aM₀ of TNM were included in the study.A total of 400 healthy women were selected as healthy controls.The EORTC QLQ-C30 scale was used to compare the general data（age,BMI）,disease related indicators（TSH,Tg）and HRQOL scores between the controls and PTC patients at preoperative period and 6 months after operation.Patients were divided into two groups according to whether they received I-131 treatment,namely I-131 treatment group（n=205）and non-I-131 treatment group（n=151）.I-131treatment was performed in 1 months after operation,and the treatment dose was3700MBq.The general data（age,BMI）,disease related indicators（TSH,Tg）and HRQOL scores at preoperative period,1,3 and 6 months postoperatively were compared between the two groups.Informed consent was obtained from all subjects.and the non parameter test of Mann-Whitney was used to compare the groups with SPSS 19.0 software.Results:There was no significant difference in age and BMI between all the patients and the controls,the I-131 treatment group and non-I-131 treatment group（p>0.05）.The median of TSH and Tg in 6 months after operation was significantly lower than that of the controls（0.12 vs.1.94,0.05 vs.16.14,p<0.01）.TSH and Tg in the I-131treatment group was significantly higher than that in the non-I-131 treatment（107.97vs.0.27,1.83 vs.0.05,p<0.01）at 1 months after the operation.The preoperative Global quality of life（GQOL）score of all the patients was significantly lower than that of the controls（59.11±21.12 vs.83.08±14.62,p<0.01）,and the scores of the remaining 12 domains other than the the two domains of physical function and pain were lower than those in the controls（p<0.05）.There was no significant difference in all domain scores between the I-131 treatment group and non-I-131 treatment group（p>0.05）.At 1 months after operation,the GQOL score in the I-131 treatment group was significantly lower than that in the non-I-131 treatment group（50.57±17.72 vs.55.74±18.82,p<0.05）,and the scores of the I-131 treatment group in other 11 areas except pain,diarrhea and economy were significantly lower than those in the non-I-131 treatment group（p<0.05）.At three months post-operation,the GQOL score in the I-131 treatment group was still lower than that in the non-I-131treatment group（64.43±32.12 vs.72.68±17.29,p<0.05）,but the scores of the I-131treatment group lower than that in the non-I-131 treatment group only in the five domains of role function,emotional function,social function,appetite loss,insomnia（p<0.05）.At 6 months after operation,there was no difference in GQOL score（73.86±18.26 vs.73.57±18.01）and any other scores between I-131 treatment group and non-I-131 treatment group（p>0.05）.At this time the GQOL scores in all the patients were still lower than the controls（73.88±18.04 vs.83.08±14.62,p<0.05）,but it was significantly higher than the preoperative scores（73.88±18.04 vs.59.11±21.12）,and there are similar improvements in the 9 other areas other than cognitive function,social function and fatigue（p<0.05）.Conclusion:I-131 treatment have no long-term impact on HRQOL in PTC patients.The HRQOL in the I-131 treatment group was lower than the non-I-131 treatment group within 6 months after operation,and the psychological factors may play an important role.Therefore,the psychological nursing for the patients should be strengthened.