Lee Yueh, Chung Chi-Hsiang, Lin Li-Fan, Chiu Chuang-Hsin, Chen Yi-Feng, Chang Chao-Feng, Cheng Cheng-Yi, Chien Wu-Chien
Department of Nuclear Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei City 11490, Taiwan.
School of Public Health, National Defense Medical Center, Taipei City 11490, Taiwan.
Cancers (Basel). 2022 May 19;14(10):2505. doi: 10.3390/cancers14102505.
(1) Background: The study aimed to investigate the association between radioactive iodine (RAI) treatment and long-term gastrointestinal disorders including ulcers, atrophic gastritis, and secondary malignant neoplasm of the stomach in patients with thyroid cancer. (2) Methods: The data of the study were extracted from the National Health Insurance Database (NHIRD) of Taiwan between 2000 to 2015. Patients of ages older than 20 with thyroid cancer after thyroidectomy were included and divided into groups with RAI (study cohort) and without RAI (comparison cohort). Multivariate Cox proportional hazards regression analysis and the Kaplan-Meier method were used for statistical analysis. (3) Results: A total of 7250 (with RAI: 5800, without RAI: 1450) patients were included. The Kaplan-Meier analysis revealed a significantly higher cumulative risk for overall gastrointestinal disorders in the group with RAI (log-rank = 0.034). The risk for gastrointestinal disorders was higher when receiving a cumulative RAI dose higher than 1.11 GBq in the Cox regression analysis. In the subgroup analysis, the risks of gastric and duodenal ulcers are significantly higher in the group with RAI treatment. (4) Conclusions: This study revealed that RAI was associated with an increased risk for long-term gastrointestinal disorders, specifically gastric and duodenal ulcers, in thyroid cancer, especially when the cumulative dose exceeds 1.11 GBq.
（1）背景：本研究旨在调查放射性碘（RAI）治疗与甲状腺癌患者长期胃肠道疾病之间的关联，这些疾病包括溃疡、萎缩性胃炎和胃继发性恶性肿瘤。（2）方法：研究数据取自台湾2000年至2015年的国民健康保险数据库（NHIRD）。纳入年龄大于20岁且甲状腺切除术后患甲状腺癌的患者，并分为接受RAI治疗的组（研究队列）和未接受RAI治疗的组（对照队列）。采用多变量Cox比例风险回归分析和Kaplan-Meier方法进行统计分析。（3）结果：共纳入7250例患者（接受RAI治疗：5800例，未接受RAI治疗：1450例）。Kaplan-Meier分析显示，接受RAI治疗的组中，总体胃肠道疾病的累积风险显著更高（对数秩检验P = 0.034）。在Cox回归分析中，当接受的RAI累积剂量高于1.11GBq时，胃肠道疾病风险更高。在亚组分析中，接受RAI治疗的组中胃溃疡和十二指肠溃疡的风险显著更高。（4）结论：本研究表明，RAI与甲状腺癌患者长期胃肠道疾病风险增加相关，尤其是胃溃疡和十二指肠溃疡风险增加，特别是当累积剂量超过1.11GBq时。
