Kao Chun-Hao, Chung Chi-Hsiang, Chien Wu-Chien, Shen Daniel Hueng-Yuan, Lin Li-Fan, Chiu Chuang-Hsin, Cheng Cheng-Yi, Sun Chien-An, Chang Ping-Ying
Department of Nuclear Medicine, Tri-Service General Hospital and National Defense Medical Center, Taipei City 11490, Taiwan.
School of Public Health, National Defense Medical Center, Taipei City 11490, Taiwan.
J Clin Med. 2021 Sep 6;10(17):4032. doi: 10.3390/jcm10174032.
(1) Background: This study aimed to investigate the association between radioactive iodine (RAI) and long-term cardiovascular disease (CVD) morbidity/mortality in thyroid cancer. (2) Methods: The study was conducted using data from the Taiwan National Health Insurance Database during 2000-2015. Thyroid cancer patients aged ≥20 years were categorized into RAI (thyroidectomy with RAI) and non-RAI (thyroidectomy only) groups. The Cox proportional hazard regression model and Kaplan-Meier method were used for analysis. (3) Results: A total of 13,310 patients were included. Kaplan-Meier analysis demonstrated that the two groups had similar cumulative risks of CVD (log-rank = 0.72) and CVD-specific mortality (log-rank = 0.62). On Cox regression analysis of different RAI doses, the risk of CVD was higher in the cumulative dosage >3.7 GBq (hazard ratio = 1.69, 95% confidence interval = 1.24-2.40, < 0.001). (4) Conclusions: RAI was not associated with an increased risk of CVD in thyroid cancer. However, CVD surveillance is indicated in the patients receiving the cumulative RAI dosage above 3.7 GBq.
(1) 背景：本研究旨在调查放射性碘（RAI）与甲状腺癌长期心血管疾病（CVD）发病率/死亡率之间的关联。(2) 方法：本研究使用了2000年至2015年台湾国民健康保险数据库的数据。年龄≥20岁的甲状腺癌患者被分为RAI组（甲状腺切除术后接受RAI治疗）和非RAI组（仅接受甲状腺切除术）。采用Cox比例风险回归模型和Kaplan-Meier方法进行分析。(3) 结果：共纳入13310例患者。Kaplan-Meier分析表明，两组的CVD累积风险（对数秩检验 = 0.72）和CVD特异性死亡率（对数秩检验 = 0.62）相似。在对不同RAI剂量进行Cox回归分析时，累积剂量>3.7 GBq的患者发生CVD的风险更高（风险比 = 1.69，95%置信区间 = 1.24 - 2.40，P < 0.001）。(4) 结论：RAI与甲状腺癌患者CVD风险增加无关。然而，接受累积RAI剂量超过3.7 GBq的患者需要进行CVD监测。
