The Effect Of Timing Of Post-operative Radioactive Iodine Administration On Outcome Of Patients With Differentiated Thyroid Cancer

Objective:Radioactive Iodine(RAI)131 treatment as one of the post-operative targeted therapies has been shown to be an effective treatment for reducing the risk of recurrence and death in moderate and high-risk differentiated Thyroid Carcinoma(DTC).In recent years,there has been increasing evidence that the improvement in the treatment and management of radioactive iodine 131 in patients with differentiated thyroid cancer has significantly improved the quality of life and prognosis of patients with differentiated thyroid cancer As a key treatment for postoperative differentiated thyroid cancer,the efficacy of radioactive iodine 131 is clear,but little research has been done on the timing of the first radioactive iodine 131 treatment.The purpose of this article is to assess the impact of the first postoperative radioiodine therapy on the early efficacy of differentiated thyroid cancer.Methods:The clinical data of 399 patients with differentiated thyroid cancer affiliated to the First Hospital of China Medical University were retrospectively analyzed.All patients underwent Total Thyroidectomy(TT).All patients underwent radioactive iodine 131 treatment in our hospital.The first radioactive iodine 131 treatment was used as the starting point for follow-up.The patient's examination and laboratory results were collected one year later to exclude patients who were lost to follow-up and clinical data.The clinical status of the patient was determined based on clinical data.The criteria for grouping:the time interval between total thyroidectomy and the first radioactive iodine 131 treatment,the patients were divided into two groups:group A(interval ? months,n=199),group B(interval>3 months),n=200).All data was processed using SPSS 20.0 statistical software.Data that approximates a normal distribution is represented by ± s.The categorical variables are expressed as a percentage.The ages were compared using an independent sample t test.The gender and pathological types were compared using the chi-square test.The tumor diameter,the dose of the first radioactive iodine 131 treatment,the clinical stage,and the recurrence risk stratification were compared using the Mann-Whitney U test.Univariate analysis used a two-class logistic regression model.Factors with P<0.1 in the univariate analysis were included in the multivariate regression analysis to further explore the risk factors affecting prognosis.P<0.05 was considered statistically significant.The efficacy of radioactive iodine 131 treatment was assessed as mitigation and persistence.Univariate and multivariate analyses were used to determine factors that influence the early efficacy of differentiated thyroid cancer.Results:According to the actual clinical situation,the availability of medical facilities in China is a key factor limiting the timing of first-time iodine 131 treatment in differentiated thyroid cancer One year after the first radioactive iodine 131 treatment in this study,each patient was clinically evaluated based on clinical tests and laboratory results.The remission rate of patients in group A(interval?3 months)was 65.3%,and the response rate in group B(interval>3 months)was 68.5%.There was no significant difference in clinical remission between the two groups(P=0.171).Univariate analysis showed that the time to initial treatment of RAI was not associated with the duration of the disease.Sex was male,pathological type was follicular carcinoma,clinical stage was IVb and IVc,and risk of recurrence was classified as intermediate risk group and high risk group.In addition,as the diameter of the tumor increases,the risk of a sustained state of the disease increases.The above independent risk factors were included in the logistic multiple regression analysis.The results showed that the tumor diameter,the clinical stage was IVc,and the risk of recurrence was classified as the intermediate risk group and the high risk group were independent risk factors for continuous disease.Multivariate logistic regression analysis showed that the timing of the first postoperative RAI treatment was not associated with persistent disease.Tumor diameter(OR=1.825;95%Cl:1.479,2.253;P<0.001),clinical stage IVc(OR=20.296;95%Cl:2.591,158.991;P=0.004),recurrence risk stratification The risk group(OR=2.359;95%Cl:1.259,4.418;P=0.007)and the high-risk group(OR=6.427,95%Cl:3.398,12.155;P<0.001)were independent risk factors for the patient's condition.Conclusion:The results of this study suggest that the implementation of radioactive iodine treatment within 6 months after the operation of differentiated thyroid cancer does not affect the early efficacy of differentiated thyroid cancer,so medical institutions and patients do not need urgent postoperative radioactive iodine 131 treatment.Our findings can alleviate the patient's anxiety about delayed radioactive iodine 131 treatment,and clinicians can determine the timing of the first postoperative radioactive iodine 131 treatment based on the patient's condition,general condition,and availability of local medical resources.