Saraçoğlu Seray, Güven Osman, Babacan Gündüzalp Buğrahan, Karyağar Savaş, Özülker Tamer, Ergür Sadık, Sağlampınar Karyağar Sevda
University of Health Sciences Turkey, Prof. Dr. Cemil Taşcıoğlu City Hospital, Clinic of Nuclear Medicine, İstanbul, Turkey.
Bursa City Hospital, Clinic of Nuclear Medicine, Bursa, Turkey.
Mol Imaging Radionucl Ther. 2023 Jun 20;32(2):112-116. doi: 10.4274/mirt.galenos.2022.05826.
The aim of this study was to compare the treatment responses after ablation with 30-50 mCi radioactive iodine (RAI) and 100 mCi RAI in patients with differentiated thyroid cancer (DTC) who were in the low-risk group according to 2015 American Thyroid Associations Classification (ATA 2015) criteria.
Between February 2016 and August 2018, 100 patients who received RAI treatment in our clinic after total thyroidectomy and who were in the low-risk group DTC were included in this retrospective study. These patients were divided into 2 groups: low-activity (30-50 mCi) (group 1) and high-activity (100 mCi) (group 2). While 54 patients were treated with low activity, 46 patients received high activity RAI. The 2 groups were compared according to the 1- and 3-year treatment response status.
According to the first-year follow-up, 15 patients were accepted as indeterminate response and 85 patients as excellent response. Three (5.5%) of the patients who were accepted as indeterminate response were in group 1 and 12 (26%) were in group 2. According to the third year follow-up, 1 patient in group 1 and 3 patients in group 2 were accepted as indeterminate response. No biochemical incomplete response or recurrent disease was detected. In the chi-square analysis performed to investigate the relationship between the first-year treatment response and RAI activities, a significant relationship was found (p=0.004). In the Mann-Whitney U test performed to investigate the parameters that may be effective in the treatment response, only the preablative serum thyroglobulin value was shown to have a significant difference between the two groups (p=0.01). In the long-term follow-up of the patients, based on the third year treatment response data, chi-square analysis was performed to evaluate the two groups in terms of treatment responses, and no statistically significant relationship was found (p=0.73).
Ablation with 30-50 mCi can be safely applied in DTC patients who are in the ATA 2015 low-risk group and are planned for RAI ablation treatment.
本研究旨在比较根据2015年美国甲状腺协会分类（ATA 2015）标准属于低风险组的分化型甲状腺癌（DTC）患者接受30 - 50毫居里放射性碘（RAI）和100毫居里RAI消融后的治疗反应。
2016年2月至2018年8月期间，100例在我院接受全甲状腺切除术后接受RAI治疗且属于低风险组DTC的患者被纳入本回顾性研究。这些患者被分为两组：低活度（30 - 50毫居里）（第1组）和高活度（100毫居里）（第2组）。54例患者接受低活度治疗，46例患者接受高活度RAI治疗。根据1年和3年的治疗反应状态对两组进行比较。
根据第一年的随访，15例患者被判定为不确定反应，85例患者为优秀反应。被判定为不确定反应的患者中，3例（5.5%）在第1组，12例（26%）在第2组。根据第三年的随访，第1组有1例患者、第2组有3例患者被判定为不确定反应。未检测到生化不完全反应或复发病例。在为研究第一年治疗反应与RAI活度之间的关系而进行的卡方分析中，发现了显著关系（p = 0.004）。在为研究可能对治疗反应有影响的参数而进行的曼 - 惠特尼U检验中，仅发现消融前血清甲状腺球蛋白值在两组之间有显著差异（p = 0.01）。在对患者的长期随访中，基于第三年治疗反应数据，进行卡方分析以评估两组的治疗反应，未发现统计学上的显著关系（p = 0.73）。
对于符合ATA 2015低风险组且计划接受RAI消融治疗的DTC患者，可安全应用30 - 50毫居里的消融治疗。
