Ming Hui, Yu Hui, Liu Yangbao, Yang Lihua, Chen Yuanhao
Department of Nuclear Medicine, Huangshi Central Hospital, Affiliated Hospital of Hubei Polytechnic University, Huangshi, China.
Jpn J Clin Oncol. 2022 Oct 6;52(10):1159-1166. doi: 10.1093/jjco/hyac113.
To investigate the effect of radioactive iodine therapy under thyroid hormone withdrawal in differentiated thyroid cancer patients on health-related quality of life.
Patients who were diagnosed with differentiated thyroid cancer after thyroidectomy were involved in this study. All of them were managed with thyroid hormone withdrawal. Health-related quality of life was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and its thyroid cancer module at three different time points. Changes in health-related quality of life were evaluated by Wilcoxon and Kruskal-Wallis tests. Univariable logistic regression analysis was used to determine social-demographic and clinical factors associated with worse health-related quality of life.
A total of 99 differentiated thyroid cancer patients were involved in this study. Changes in health-related quality of life at different time points showed that 1 month post-radioactive iodine treatment, an improvement in nausea and vomiting, insomnia and appetite loss was observed. Impairments of global health, role, cognitive and social function and problems of discomfort in the head and neck, voice concerns, dry mouth, fatigue, pain, dyspnea, thyroid fatigue, fear, tingling or numbness, joint pain and shoulder function increased after radioactive iodine treatment. Univariable logistic regression analysis demonstrated potential factors associated with worse health-related quality of life. Thyroid stimulating hormone and parathyroid hormone levels were more sensible to changes in functional domain. Patients aged ≥55-year-old, with annual income under ¥50 000, low parathyroid hormone and pT4 tumour stage experienced higher changes in symptom scales after radioactive iodine treatment.
After radioactive iodine treatment, differentiated thyroid cancer patients experienced negative health-related quality of life, and most of these impairments might not recover in the short term. Thyroid stimulating hormone and parathyroid hormone levels, annual income and pT tumours stage were independent risk factors for decreased health-related quality of life.
探讨分化型甲状腺癌患者在甲状腺激素撤减状态下接受放射性碘治疗对健康相关生活质量的影响。
本研究纳入甲状腺切除术后诊断为分化型甲状腺癌的患者。所有患者均接受甲状腺激素撤减治疗。在三个不同时间点，使用欧洲癌症研究与治疗组织生活质量问卷核心30项及其甲状腺癌模块评估健康相关生活质量。采用Wilcoxon检验和Kruskal-Wallis检验评估健康相关生活质量的变化。采用单因素逻辑回归分析确定与健康相关生活质量较差相关的社会人口学和临床因素。
本研究共纳入99例分化型甲状腺癌患者。不同时间点健康相关生活质量的变化显示，放射性碘治疗后1个月，恶心呕吐、失眠和食欲减退有所改善。放射性碘治疗后，总体健康、角色、认知和社会功能受损，以及头颈部不适、声音问题、口干、疲劳、疼痛、呼吸困难、甲状腺疲劳、恐惧、刺痛或麻木、关节疼痛和肩部功能问题增加。单因素逻辑回归分析显示了与健康相关生活质量较差相关的潜在因素。促甲状腺激素和甲状旁腺激素水平对功能领域的变化更敏感。年龄≥55岁、年收入低于5万元、甲状旁腺激素水平低和pT4肿瘤分期的患者在放射性碘治疗后症状量表变化更大。
放射性碘治疗后，分化型甲状腺癌患者的健康相关生活质量出现负面变化，且这些损害大多在短期内无法恢复。促甲状腺激素和甲状旁腺激素水平、年收入和pT肿瘤分期是健康相关生活质量下降的独立危险因素。
