Influential factors on the effectiveness of 131I treatment on post-surgical differentiated thyroid cancer patients / 中华核医学杂志

ABSTRACT

Objective To investigate the influential factors on the effectiveness of the first 131I ablation therapy on thyroid remnant and of 131I treatment on metastatic lesions in differentiated thyroid cancer (DTC) patients. Methods Retrospectively,46 DTC cases (divided into complete-ablation group and incomplete-ablation group) of first 131I ablation were enrolled,and 40 DTC cases (divided into remission group and in-remission group) of consecutive 131I treatments on metastatic lesions were enrolled. Influential factors were analyzed (t-test,t'-test,x2-test,Fisher exact test) and logistic regression analysis was performed. Results For the first 131I ablation effectiveness,surgical method,remnant thyroid weight,thyroid stimulating hormone (TSH) level,interval between surgery and 131I ablation therapy,metastatic status were selected as influential factors (x2 = 5. 804,t' = - 5. 258,t' = 7. 376,x2 = 8. 867,x2 = 8. 615,all P ＜0. 05). After logistic regression analysis,formula was obtained as y = 3. 766 - 0. 947x1 ( remnant thyroid weight) -3. 149 x2 (lymph node metastasis) -3. 373 x3 (distant metastasis). For metastatic treatment effectiveness,remission rate of papillary DTC was higher than that of follicular DTC,remission rate of patients with lymph node metastasis was higher than that of distant metastasis,remission rate of total thyroidectomy was higher than that of other types of thyroidectomy ( Fisher exact test,x2 = 7. 278,P ＜ 0. 05 ). In remission group,serum TSH level was much higher and thyroglobulin (Tg) level was much lower before the first ablation therapy (t =4. 489,t' = -4.906,all P ＜0.01 ). After logistic regression analysis,formula was obtained as y = - 0. 363 + 0. 065 x4 ( TSH level) - 0. 250 x5 ( Tg level). Conclusions Influential factors of success rate of the first 131I ablation therapy included surgical method,remnant thyroid weight,TSH level,interval between surgery and 131I ablation therapy and metastatic status,while determinant factors were thyroid remnant weight,lymph node metastatic status and distant metastatic status. The influential factors of success rate of 131I treatment on metastatic lesions included pathological type,surgical method,metastatic status,TSH level and Tg level,while determinant factors were TSH level and Tg level before the first 131I ablation therapy.