Prognostic disparities between radioactive iodine-refractory and non-refractory DTC patients: a cohort study on survival rates and independent risk factors.

IF 3.1 4区医学 Q2 ONCOLOGY

Future oncology Pub Date : 2026-08-01 Epub Date: 2026-08-10 DOI:10.1080/14796694.2026.2715231

Menghua Xia, Weifu Lv, Wei Zhao, Liqin Bi, Xueran Guo, Mengxia Zhang, Liangping Shi

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引用次数: 0

Abstract

Aims: Patients with distant metastases of differentiated thyroid cancer (DM-DTC) exhibit significant heterogeneity in clinical characteristics and prognosis. This study aimed to investigate prognostic variables affecting overall survival (OS) in radioiodine-refractory (RAIR) patients and to predict the radioiodine therapy (RAIT) response and stimulated thyroglobulin (sTg) levels in non-radioiodine-refractory (NRAIR) patients.

Methods: A retrospective analysis was conducted on 146 patients of DM-DTC undergoing RAIT, categorizing them into an RAIR group (n = 56) and an NRAIR group (n = 90). Kaplan-Meier assessed survival, Cox regression identified RAIR prognostic factors, and logistic regression explored sTg-treatment response in NRAIR.

Results: The median follow-up period was 71 months (IQR: 24-132 months).In RAIR, brain metastasis (HR = 5.49, 95% CI: 1.46-20.66, p = 0.012) and other-site metastases (HR = 4.11, 95% CI: 1.06-15.85, p = 0.004) were independent poor prognostic factors. In NRAIR, sTg ≤ 75 ng/mL predicted favorable response (sensitivity 84.8%, specificity 78.9%).

Conclusions: RAIR status significantly impacts DM-DTC prognosis. Brain metastases or other-site metastases are independent prognostic factors in RAIR patients, highlighting the need for stratified treatment. In NRAIR patients, preliminary data suggest that sTg ≤ 75 ng/mL predicts a favorable treatment response.

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放射性碘难治性和非难治性DTC患者预后差异：生存率和独立危险因素的队列研究

目的：分化型甲状腺癌（DM-DTC）远处转移患者的临床特征和预后具有显著的异质性。本研究旨在探讨影响放射性碘难治性（RAIR）患者总生存期（OS）的预后变量，并预测非放射性碘难治性（NRAIR）患者的放射性碘治疗（RAIT）反应和促甲状腺球蛋白（sTg）水平。方法：对146例行RAIT的DM-DTC患者进行回顾性分析，将其分为RAIR组（n = 56）和NRAIR组（n = 90）。Kaplan-Meier评估生存期，Cox回归确定RAIR预后因素，logistic回归探讨stg治疗对NRAIR的影响。结果：中位随访时间为71个月（IQR: 24-132个月）。在RAIR中，脑转移（HR = 5.49, 95% CI: 1.46 ~ 20.66, p = 0.012）和其他部位转移（HR = 4.11, 95% CI: 1.06 ~ 15.85, p = 0.004）是独立的预后不良因素。在NRAIR中，sTg≤75 ng/mL预测良好的反应（敏感性84.8%，特异性78.9%）。结论：RAIR状态显著影响DM-DTC预后。脑转移或其他部位转移是RAIR患者的独立预后因素，强调分层治疗的必要性。在NRAIR患者中，初步数据显示sTg≤75 ng/mL预示着良好的治疗反应。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Future oncology ONCOLOGY-

CiteScore

5.40

自引率

3.00%

发文量

335

审稿时长

4-8 weeks

期刊介绍： Future Oncology (ISSN 1479-6694) provides a forum for a new era of cancer care. The journal focuses on the most important advances and highlights their relevance in the clinical setting. Furthermore, Future Oncology delivers essential information in concise, at-a-glance article formats - vital in delivering information to an increasingly time-constrained community. The journal takes a forward-looking stance toward the scientific and clinical issues, together with the economic and policy issues that confront us in this new era of cancer care. The journal includes literature awareness such as the latest developments in radiotherapy and immunotherapy, concise commentary and analysis, and full review articles all of which provide key findings, translational to the clinical setting.