Effects of postoperative doses of radioiodine therapy on survival and quality of life of patients with differentiated thyroid cancer

ZHANG Xiurong; CHEN Yanping; YANG Yanhao; LIU Xiaoyu

doi:10.3969/j.issn.2097-1753.2025.04.014

Abstract：Objective To investigate the effect of doses of radioactive iodine-131(131I)therapy on survival and quality of life of patients with differentiated thyroid cancer(DTC).Methods The clinical data of 126 DTC patients who received 131I treatment after total thyroidectomy between 2017 and 2020 at Quanzhou First Hospital was retrospectively analyzed.The patients were divided into group A(53 patients,1.1 GBq),group B(45 patients,3.7 GBq),and group C(28 patients,5.5 GBq)according to the dose of 131I treatment before the clearance rate of residual thyroid tissue,the incidence of tumor recurrence or metastasis,adverse reactions,overall survival(OS),disease-free survival(DFS)and scores of quality of life were compared.Results There were no statistically significant differences in the clearance rate of thyroid residual tissue or the incidence of tumor recurrence or metastasis between the three groups(P＞0.05).The incidence of hematologic adverse reactions in Group C was higher than in Groups A and B(all P＜0.05).Multivariate analysis showed that the 131I dose(HR=1.989,95%CI=1.029～3.845)and age(HR=1.080,95%CI=1.008～1.157)were risk factors for the survival curve.Postoperative complications(HR=0.066,95%CI=0.014～0.301)was protective factor for the survival curve.The SF-36 scores of group A were higher than those of groups B and C(P=0.046,P＜0.001),and higher in group B than in group C(P=0.020).EQ-5D scores were higher in Group A than in Group C(P=0.002).The levels of thyroglobulin(Tg),thyroglobulin antibody(TgAb),thyroid stimulating hormone(TSH),and parathyroid hormone(PTH)in Group B were lower than in Groups A and C(P＜0.001 or P＜0.05).Conclusion In patients with DTC,the dose of 131I therapy should be chosen based on the individual patient's condition.Too high a dose may increase the risk of adverse effects,lower the patient's quality of life,and impact the patient's physical,psychological,and social functioning.