分化型甲状腺癌患者的第二次放射性碘治疗：原因和影响

IF 1.8 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Endocrinologia Diabetes Y Nutricion Pub Date : 2024-01-01 DOI:10.1016/j.endien.2024.02.001

María de las Nieves Sicilia Pozo , Francisco José Pena Pardo , Mariano Amo Salas , Marcos Cruz Montijano , Javier Torres Hernández , Amanda Padilla Bermejo , Cristina Montalbán Méndez , María Zhao Montero , Ángel Soriano Castrejón , Ana María García Vicente

{"title":"分化型甲状腺癌患者的第二次放射性碘治疗：原因和影响","authors":"María de las Nieves Sicilia Pozo , Francisco José Pena Pardo , Mariano Amo Salas , Marcos Cruz Montijano , Javier Torres Hernández , Amanda Padilla Bermejo , Cristina Montalbán Méndez , María Zhao Montero , Ángel Soriano Castrejón , Ana María García Vicente","doi":"10.1016/j.endien.2024.02.001","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p>Patients with incomplete response to initial therapy of thyroid cancer can be managed with ongoing observation or potentially additional therapies.</p><p>Our aim was to assess the effect of a second radioactive iodine treatment (RAIT) and its relationship with causes and clinical variables.</p></div><div><h3>Material and methods</h3><p>Patients undergoing a second RAIT for biochemical or structural incomplete response to initial therapy of DTC were retrospectively included (<em>n</em>  =29.400, <em>p</em>  =44.914, <em>p</em>  =30.914, <em>p</em>  =8.460, <em>p</em>  =10.694, <em>p</em>  =8.485, <em>p</em>  =120). They were categorised based on the American Thyroid Association (ATA) classification of response to initial therapy.</p><p>Patients were reclassified in the following 6–18 months after second RAIT based on imaging findings and measurements of thyroglobulin and antithyroglobulin antibody levels.</p><p>The associations of a downgrading of response category and progression-free survival (PFS), and the related variables, were evaluated.</p></div><div><h3>Results</h3><p>Sixty-six patients (55%) had a downgrading on ATA response category after second RAIT. A significant interdependence of causes for second RAIT and outcomes was found (<em>χ</em><sup>2</sup>  =0.001), with patients with neck reoperation showing a higher rate of indeterminate or excellent responses.</p><p>A significant association between ATA response to second RAIT and absence of structural progression was found (<em>χ</em><sup>2</sup>  <0.001), with less structural progression in patients with downgrading on ATA response (<em>χ</em><sup>2</sup>  <0.001). There was also significant interdependence to some clinical variables, such as AJCC stage (<em>χ</em><sup>2</sup>  =0.015), ATA risk classification (<em>χ</em><sup>2</sup>  =0.005) and initial N stage (<em>χ</em><sup>2</sup>  =0.004).</p></div><div><h3>Conclusions</h3><p>In selected cases, a second RAIT could lead to more robust responses with a potential improvement in prognosis in patients with incomplete response to initial DTC treatment.</p></div>\",\"PeriodicalId\":48650,\"journal\":{\"name\":\"Endocrinologia Diabetes Y Nutricion\",\"volume\":\"71 1\",\"pages\":\"Pages 4-11\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2024-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Endocrinologia Diabetes Y Nutricion\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2530018024000064\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Endocrinologia Diabetes Y Nutricion","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2530018024000064","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}

引用次数: 0

摘要

我们的目的是评估第二次放射性碘治疗（RAIT）的效果及其与病因和临床变量的关系。材料与方法回顾性纳入了因DTC初始治疗生化或结构不完全反应而接受第二次RAIT的患者（n = 120）。根据影像学结果以及甲状腺球蛋白和抗甲状腺球蛋白抗体水平的测量结果，在第二次RAIT后的6-18个月内对患者进行重新分类。结果66例患者（55%）在第二次RAIT后的ATA反应类别出现降级。发现第二次 RAIT 的原因与结果之间存在明显的相互依存关系（χ2 = 29.400，P = 0.001），颈部再次手术患者的不确定或极佳反应率较高。研究发现，第二次 RAIT 的 ATA 反应与无结构性进展之间存在明显关联（χ2 = 44.914，p = 0.001），ATA 反应降级患者的结构性进展较少（χ2 = 30.914，p = 0.001）。结论在选定的病例中，第二次RAIT可导致更强的反应，并有可能改善对初始DTC治疗反应不完全的患者的预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Second radioiodine treatment in patients with differentiated thyroid carcinoma: Causes and effects

Introduction

Patients with incomplete response to initial therapy of thyroid cancer can be managed with ongoing observation or potentially additional therapies.

Our aim was to assess the effect of a second radioactive iodine treatment (RAIT) and its relationship with causes and clinical variables.

Material and methods

Patients undergoing a second RAIT for biochemical or structural incomplete response to initial therapy of DTC were retrospectively included (n = 120). They were categorised based on the American Thyroid Association (ATA) classification of response to initial therapy.

Patients were reclassified in the following 6–18 months after second RAIT based on imaging findings and measurements of thyroglobulin and antithyroglobulin antibody levels.

The associations of a downgrading of response category and progression-free survival (PFS), and the related variables, were evaluated.

Results

Sixty-six patients (55%) had a downgrading on ATA response category after second RAIT. A significant interdependence of causes for second RAIT and outcomes was found (χ² = 29.400, p = 0.001), with patients with neck reoperation showing a higher rate of indeterminate or excellent responses.

A significant association between ATA response to second RAIT and absence of structural progression was found (χ² = 44.914, p < 0.001), with less structural progression in patients with downgrading on ATA response (χ² = 30.914, p < 0.001). There was also significant interdependence to some clinical variables, such as AJCC stage (χ² = 8.460, p = 0.015), ATA risk classification (χ² = 10.694, p = 0.005) and initial N stage (χ² = 8.485, p = 0.004).

Conclusions

In selected cases, a second RAIT could lead to more robust responses with a potential improvement in prognosis in patients with incomplete response to initial DTC treatment.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Endocrinologia Diabetes Y Nutricion Multiple-

CiteScore

2.10

自引率

10.50%

发文量

期刊介绍： Endocrinología, Diabetes y Nutrición is the official journal of the Spanish Society of Endocrinology and Nutrition (Sociedad Española de Endocrinología y Nutrición, SEEN) and the Spanish Society of Diabetes (Sociedad Española de Diabetes, SED), and was founded in 1954. The aim of the journal is to improve knowledge and be a useful tool in practice for clinical and laboratory specialists, trainee physicians, researchers, and nurses interested in endocrinology, diabetes, nutrition and related disciplines. It is an international journal published in Spanish (print and online) and English (online), covering different fields of endocrinology and metabolism, including diabetes, obesity, and nutrition disorders, as well as the most relevant research produced mainly in Spanish language territories. The quality of the contents is ensured by a prestigious national and international board, and by a selected panel of specialists involved in a rigorous peer review. The result is that only manuscripts containing high quality research and with utmost interest for clinicians and professionals related in the field are published. The Journal publishes Original clinical and research articles, Reviews, Special articles, Clinical Guidelines, Position Statements from both societies and Letters to the editor. Endocrinología, Diabetes y Nutrición can be found at Science Citation Index Expanded, Medline/PubMed and SCOPUS.