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Clinicopathologic risk factors of radioactive iodine therapy based on response assessment in patients with differentiated thyroid cancer: a multicenter retrospective cohort study

Authors
 Seong Young Kwon  ;  Sang-Woo Lee  ;  Eun Jung Kong  ;  Keunyoung Kim  ;  Byung Il Kim  ;  Jahae Kim  ;  Heeyoung Kim  ;  Seol Hoon Park  ;  Jisun Park  ;  Hye Lim Park  ;  So Won Oh  ;  Kyoung Sook Won  ;  Young Hoon Ryu  ;  Joon-Kee Yoon  ;  Soo Jin Lee  ;  Jong Jin Lee  ;  Ari Chong  ;  Young Jin Jeong  ;  Ju Hye Jeong  ;  Young Seok Cho  ;  Arthur Cho  ;  Gi Jeong Cheon  ;  Eun Kyoung Choi  ;  Jae Pil Hwang  ;  Sang Kyun Bae 
Citation
 EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING, Vol.47(3) : 561-571, 2020-03 
Journal Title
EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING
ISSN
 1619-7070 
Issue Date
2020-03
Keywords
Differentiated thyroid carcinoma ; Radioactive iodine therapy ; Recombinant human thyrotropin ; Response to therapy
Abstract
Purpose: We investigated whether predictive clinicopathologic factors can be affected by different response criteria and how the clinical usefulness of radioactive iodine (RAI) therapy should be evaluated considering variable factors in patients with differentiated thyroid carcinoma (DTC). Methods: A total of 1563 patients with DTC who underwent first RAI therapy after total or near total thyroidectomy were retrospectively enrolled from 25 hospitals. Response to therapy was evaluated with two different protocols based on combination of biochemical and imaging studies: (1) serum thyroglobulin (Tg) and neck ultrasonography (US) and (2) serum Tg, neck US, and radioiodine scan. The responses to therapy were classified into excellent and non-excellent or acceptable and non-acceptable to minimize the effect of non-specific imaging findings. We investigated which factors were associated with response to therapy depending on the follow-up protocols as well as response classifications. Multivariate logistic regression analysis was performed to identify factors significantly predicting response to therapy. Results: The proportion of patients in the excellent response group significantly decreased from 76.5 to 59.6% when radioiodine scan was added to the follow-up protocol (P < 0.001). Preparation method (recombinant human TSH vs. thyroid hormone withdrawal) was a significant factor for excellent response prediction evaluated with radioiodine scan (OR 2.129; 95% CI 1.687-2.685; P < 0.001) but was not for other types of response classifications. Administered RAI activity, which was classified as low (1.11 GBq) or high (3.7 GBq or higher), significantly predicted both excellent and acceptable responses regardless of the follow-up protocol. Conclusions: The clinical impact of factors related to response prediction differed depending on the follow-up protocol or classification of response criteria. A high administered activity of RAI was a significant factor predicting a favorable response to therapy regardless of the follow-up protocol or classification of response criteria.
Full Text
https://link.springer.com/article/10.1007%2Fs00259-019-04634-8
DOI
10.1007/s00259-019-04634-8
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
Yonsei Authors
Ryu, Young Hoon(유영훈) ORCID logo https://orcid.org/0000-0002-9000-5563
Cho, Arthur Eung Hyuck(조응혁) ORCID logo https://orcid.org/0000-0001-8670-2473
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/182738
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