Wang Jinmiao, Hao Jie, Gao Ying, Wang Shoujun, Wang Duowei, Tao Weijie, Duan Ran, Zhang Zhendong, Gao Ming
Department of Thyroid Surgery, Tianjin Union Medical Center, Nankai University, Tianjin, China.
Department of General Surgery, Tianjin Medical University General Hospital, Tianjin, China.
Oncology. 2025;103(5):360-368. doi: 10.1159/000541546. Epub 2024 Sep 20.
This study aimed to evaluate the clinical value of iodine-131 combined with levothyroxine sodium in the treatment of patients with differentiated thyroid cancer (DTC) after surgery.
Prospective randomized controlled studies were conducted. A total of 374 DTC patients who underwent total or near-total thyroidectomy in the Department of Thyroid Surgery, Tianjin Union Medical Center and Tianjin Medical University General Hospital, from January 2019 to February 2022 were selected and divided into control group (187 cases) and observation group (187 cases) according to random number table method. The control group was treated with levothyroxine sodium after surgery, and the observation group was treated with iodine-131 on the basis of the control group. Gender, age, course of disease, tumor diameter, pathological type, TNM classification, treatment effect, thyroglobulin (Tg) levels before and after treatment, SF-36 health status questionnaires (SF-36), occurrence of adverse reactions after treatment, and recurrence rate of 1-year follow-up were compared and analyzed between the two groups.
There was no significant difference in baseline data between the two groups. After treatment, the effective rate of the observation group increased by 11.23% compared to the control group, with a statistically significant difference (91.98% vs. 80.75%, p < 0.05). There was no significant difference in Tg level and scores of SF-36 evaluation including physical functioning, physical problems, vitality, pain, mental health, emotional problems, social functioning, and general health perception between the two groups before surgery (p > 0.05), Tg levels and scores of SF-36 evaluation in all dimensions were significantly improved in both groups after treatment (p < 0.05), and the levels of Tg and scores of SF-36 in all dimensions in observation group were significantly better than those in control group after treatment (p < 0.001). There was no significant difference in the incidence of adverse reactions between the two groups (p > 0.05). The recurrence rate in the observation group was 5.89% lower than that in the control group 1 year after treatment, with a statistically significant difference (2.67% vs. 8.56%, p < 0.05).
The combination of iodine-131 and levothyroxine sodium in the postoperative treatment of DTC can improve the therapeutic effect and reduce the postoperative recurrence rate without increasing adverse reactions, which is worthy of clinical reference and promotion.
本研究旨在评估碘-131联合左甲状腺素钠治疗分化型甲状腺癌（DTC）患者术后的临床价值。
进行前瞻性随机对照研究。选取2019年1月至2022年2月在天津医科大学总医院和天津市联合医疗中心甲状腺外科接受全甲状腺切除或近全甲状腺切除的374例DTC患者，根据随机数字表法分为对照组（187例）和观察组（187例）。对照组术后接受左甲状腺素钠治疗，观察组在对照组基础上加用碘-131治疗。比较分析两组患者的性别、年龄、病程、肿瘤直径、病理类型、TNM分期、治疗效果、治疗前后甲状腺球蛋白（Tg）水平、SF-36健康状况调查问卷（SF-36）、治疗后不良反应发生情况及1年随访复发率。
两组患者基线资料比较，差异无统计学意义。治疗后，观察组有效率较对照组提高11.23%，差异有统计学意义（91.98% vs. 80.75%，p < 0.05）。术前两组患者Tg水平及SF-36各维度评分（包括生理功能、身体问题、活力、疼痛、心理健康、情绪问题、社会功能和总体健康感知）比较，差异无统计学意义（p > 0.05）；治疗后两组患者Tg水平及SF-36各维度评分均显著改善（p < 0.05），且观察组治疗后Tg水平及SF-36各维度评分均显著优于对照组（p < 0.001）。两组患者不良反应发生率比较，差异无统计学意义（p > 0.05）。治疗后1年，观察组复发率较对照组低5.89%，差异有统计学意义（2.67% vs. 8.56%，p < 0.05）。
碘-131联合左甲状腺素钠用于DTC患者术后治疗，可提高治疗效果，降低术后复发率，且不增加不良反应，值得临床参考推广。
