Comparison of effects of SPECT-CT and conventional CT-guided implantation of 125I seeds on salivary gland function and survival prognosis in patients with radioiodine-refractory differentiated thyroid cancer

YUAN Hui; RUAN Yi

doi:10.3969/j.issn.1674-3806.2025.09.17

Abstract：Objective To compare and analyze the effects of single-photon emission computed tomography-computed tomography(SPECT-CT)and conventional computed tomography(CT)-guided implantation of 125I seeds on salivary gland function and survival prognosis in patients with radioiodine-refractory differentiated thyroid cancer(RAIR-DTC).Methods A total of 116 patients with RAIR-DTC who were admitted to Changde Hospital,Xiangya School of Medicine,Central South University(the First People's Hospital of Changde City)from February 2016 to February 2019 were selected and divided into observation group and control group according to random envelope method,with 58 patients in each group.The control group underwent conventional CT-guided implantation of 125I seeds,while the observation group underwent SPECT-CT-guided implantation of 125I seeds.The clinical efficacy,salivary gland function,European Quality of Life Five-Dimension Five-Level Scale(EQ-5D-5L)scores,incidence of adverse reactions and survival prognosis within 5 years after treatment were compared between the two groups.Results The disease control rate of the observation group was significantly higher than that of the control group(P＜0.05).At 3 months(T1)and 6 months(T2)after treatment,the maximum concentration rate(MAR)of the parotid gland,the maximum secretion rate(MSR)of the parotid gland after acid stimulation,the MAR of the submandibular gland,and the MSR of the submandibular gland were significantly lower than those before treatment(T0)in the two groups(P＜0.05).At the time points of T,and T2,the MAR of the parotid gland,the MSR of the parotid gland,the MAR of the submandibular gland,and the MSR of the submandibular gland in the observation group were significantly higher than those in the control group(P＜0.05).The EQ-5D-5L scores in the two groups at the time points of T,and T2 were significantly higher than those at the time point of T0(P＜0.05).The EQ-5D-5L scores at the time points ofT1and T2 in the observation group were significantly higher than those in the control group(P＜0.05).The incidence of adverse reactions in the observation group was significantly lower than that in the control group(P＜0.05).After the treatment,the 5-year survival rate was 89.66％in the observation group,and 75.86％in the control group.The survival prognosis of the observation group was significantly better than that of the control group(log-rank test:x2=3.867,P=0.035).Conclusion Compared with conventional CT-guided implantation of 125I seeds,SPECT-CT-guided implantation of 125I seeds has a definite therapeutic effect in treatment of patients with RAIR-DTC.The SPECT-CT-guided implantation of 125I seeds can effectively improve the salivary gland function,quality of life and survival prognosis of the patients.