Krajewska Jolanta, Jarzab Michal, Kukulska Aleksandra, Czarniecka Agnieszka, Roskosz Jozef, Puch Zbigniew, Wygoda Zbigniew, Paliczka-Cieslik Ewa, Kropinska Aleksandra, Krol Aleksandra, Handkiewicz-Junak Daria, Jarzab Barbara
Nuclear Medicine and Endocrine Oncology Department, M.Sklodowska-Curie Institute-Oncology Center, Gliwice Branch, Wybrzeze AK 15, 44-101 Gliwice, Poland.
IIIrd Radiotherapy Clinic, M.Sklodowska-Curie Institute-Oncology Center, Gliwice Branch, Gliwice, Poland.
Nucl Med Mol Imaging. 2019 Oct;53(5):320-327. doi: 10.1007/s13139-019-00608-8. Epub 2019 Sep 5.
Although postoperative radioiodine (RAI) therapy has been used in patients with differentiated thyroid carcinoma (DTC) for many years, there is still lack of data defining the timing of RAI administration. A retrospective analysis was carried out to answer the question whether the time of postoperative RAI treatment demonstrated any impact on long-term outcomes, particularly in low-risk DTC.
The analyzed group involved 701 DTC patients staged pT-TN-NM, who underwent total thyroidectomy and postoperative RAI therapy. According to the time interval between DTC diagnosis and RAI administration, patients were allocated to one of three groups: up to 9 months ( = 150), between 9 and 24 months ( = 323), and > 24 months ( = 228). Median follow-up was 12.1 years (1.5-15.2).
Based on an initial DTC advancement and postoperative stimulated thyroglobulin concentration patients were stratified as a low-, intermediate-, and high-risk group. Low-risk patients, who received RAI therapy up to 9 months, demonstrated significantly lower risk of relapse comparing to those, in whom RAI was administered between 9 and 24 months and after 24 months since DTC diagnosis: 0%, 5.5%, and 7.1%, respectively. Regarding intermediate- and high-risk groups, the differences in the timing of postoperative RAI treatment were not significant.
If postoperative RAI treatment is considered in low-risk DTC, any delay in RAI administration above 9 months since diagnosis may be related to poorer long-term outcomes.
尽管术后放射性碘（RAI）治疗已在分化型甲状腺癌（DTC）患者中应用多年，但仍缺乏关于RAI给药时机的数据。进行了一项回顾性分析，以回答术后RAI治疗时间是否对长期预后有任何影响的问题，特别是在低风险DTC患者中。
分析组包括701例分期为pT-TN-NM的DTC患者，他们接受了甲状腺全切除术和术后RAI治疗。根据DTC诊断与RAI给药之间的时间间隔，患者被分为三组之一：9个月以内（n = 150）、9至24个月之间（n = 323）和超过24个月（n = 228）。中位随访时间为12.1年（1.5 - 15.2年）。
根据初始DTC进展情况和术后刺激甲状腺球蛋白浓度，患者被分层为低、中、高风险组。与在DTC诊断后9至24个月之间以及24个月后接受RAI治疗的患者相比，在9个月以内接受RAI治疗的低风险患者复发风险显著更低：分别为0%、5.5%和7.1%。对于中、高风险组，术后RAI治疗时间的差异不显著。
如果考虑对低风险DTC患者进行术后RAI治疗，自诊断起超过9个月的RAI给药延迟可能与较差的长期预后相关。
