Indra Bima, Qodir Nur, Pramudhito Didit, Legiran Legiran, Hafy Zen, Yusran Andi M Iqbal
Faculty of Medicine, University of Sriwijaya, Palembang, Indonesia.
Department of Surgery, University of Sriwijaya/ Mohammad Hoesin General Hospital, Palembang, Indonesia.
J Egypt Natl Canc Inst. 2025 May 21;37(1):39. doi: 10.1186/s43046-025-00293-z.
The effectiveness of radioiodine therapy (RAI) in reducing recurrence and improving overall survival in differentiated thyroid carcinoma (DTC) remains debated. This systematic review evaluates the impact of RAI on DTC recurrence and survival.
A comprehensive search was conducted across PubMed, ScienceDirect, Web of Science, CINAHL, and Tripdatabase, including studies from inception to August 2024. Only studies published in English with full-text availability were included. Risk of bias was assessed using the Revised Risk of Bias Assessment Tool for Nonrandomized Studies of Interventions (RoBANS 2).
Nine studies were included, involving 161,703 participants (36,658 men and 125,045 women). The studies were geographically diverse, with four from the American continent, three from Asia, and two from Europe. RAI doses ranged from 30 to 300 mCi, with 30 mCi and 100 mCi being the most common. Five studies found that RAI reduced recurrence, while two found no significant effect. The median time to recurrence ranged from 10 months to 15 years, with most studies indicating a 1-2-year median. Regarding overall survival, two studies reported improvement with successful RAI therapy, while two found no significant impact.
RAI therapy shows potential in reducing recurrence in DTC, particularly within the first 2-year post-treatment, but its effect on overall survival remains unclear. Further high-quality research is necessary to confirm these findings and guide clinical practice.
放射性碘治疗（RAI）在降低分化型甲状腺癌（DTC）复发率和提高总生存率方面的有效性仍存在争议。本系统评价评估了RAI对DTC复发和生存的影响。
对PubMed、ScienceDirect、Web of Science、CINAHL和Tripdatabase进行了全面检索，纳入了从创刊至2024年8月的研究。仅纳入以英文发表且有全文的研究。使用干预性非随机研究的修订偏倚风险评估工具（RoBANS 2）评估偏倚风险。
纳入9项研究，涉及161,703名参与者（36,658名男性和125,045名女性）。这些研究地域分布广泛，其中4项来自美洲大陆，3项来自亚洲，2项来自欧洲。RAI剂量范围为30至300毫居里，最常见的是30毫居里和100毫居里。5项研究发现RAI可降低复发率，而2项研究未发现显著效果。复发的中位时间为10个月至15年，大多数研究表明中位时间为1至2年。关于总生存率，2项研究报告成功的RAI治疗可改善生存率，而2项研究未发现显著影响。
RAI治疗在降低DTC复发率方面显示出潜力，尤其是在治疗后的前2年内，但其对总生存率的影响仍不明确。需要进一步的高质量研究来证实这些发现并指导临床实践。
