Department of Nuclear Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
Ann Nucl Med. 2024 Sep;38(9):688-699. doi: 10.1007/s12149-024-01963-z. Epub 2024 Jul 24.
Differentiated thyroid cancer (DTC) is the most common endocrine malignancy. Patients who receive systematic care typically have a better prognosis. RAI treatment plays a key role in eradicating any remaining thyroid lesions in DTC patients, hence decreasing the risk of distant metastases and cancer recurrence. As research continues to advance, RAI treatment is becoming more and more individualized. Because of the excellent prognosis for DTC patients, there is a relatively broad window for RAI treatment, making it easy to overlook when to receive RAI treatment. However, research on this issue can help patients with varying recurrence risk stratification make better decisions about when to begin RAI treatment following surgery, and physicians can schedule patients based on the severity of their disease. This will improve patient prognosis and lessen needless anxiety in addition to helping solve the problems of unjust healthcare resource distribution. In this review, we will mainly discuss the target population of RAI treatment as well as studies that examine the impact of RAI treatment timing on patient outcomes. In an effort to discourage DTC patients and physicians from selecting RAI therapy at random, we also review the possible negative effects of this treatment.
分化型甲状腺癌(DTC)是最常见的内分泌恶性肿瘤。接受系统治疗的患者通常预后较好。放射性碘(RAI)治疗在消除 DTC 患者残留甲状腺病变方面发挥着关键作用,从而降低远处转移和癌症复发的风险。随着研究的不断推进,RAI 治疗变得越来越个体化。由于 DTC 患者的预后良好,RAI 治疗有一个相对较宽的窗口期,因此很容易忽视何时进行 RAI 治疗。然而,对这一问题的研究可以帮助具有不同复发风险分层的患者更好地决定手术后何时开始 RAI 治疗,医生可以根据疾病的严重程度为患者安排治疗时间。这不仅有助于解决不公平的医疗资源分配问题,还可以改善患者的预后,减轻不必要的焦虑。在这篇综述中,我们将主要讨论 RAI 治疗的目标人群,以及研究 RAI 治疗时机对患者结局的影响。为了防止 DTC 患者和医生随意选择 RAI 治疗,我们还回顾了这种治疗可能产生的负面影响。