癌症甲状腺患者放射性碘治疗后第二原发性恶性肿瘤的全国性研究

IF 1.3 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Nuclear Medicine and Molecular Imaging Pub Date : 2023-12-01 Epub Date: 2023-08-18 DOI:10.1007/s13139-023-00818-1

Chae Moon Hong, Junik Son, Min Kyung Hyun, Jang Won Lee, Jaetae Lee

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引用次数: 0

摘要

目的:利用国民健康保险服务(NHIS)数据库，探讨放射性碘(RAI)治疗后甲状腺癌患者发生第二原发恶性肿瘤的风险。方法:我们从韩国的NHIS数据库中提取数据，该数据库涵盖了该国的全部人口。我们比较了接受RAI治疗的甲状腺癌患者与仅接受手术治疗的甲状腺癌患者发生第二原发性恶性肿瘤的风险。结果:在2004年1月1日至2018年12月31日期间，我们确定了363,155例因甲状腺癌接受甲状腺手术的患者进行分析。仅手术队列为215,481例，RAI队列为147,674例。共有19,385例患者发生第二原发性恶性肿瘤(实体癌，18,285例;血液病，1100)。总累积剂量为100mci或更低的患者发生第二原发恶性肿瘤的风险没有显著增加(风险比[HR]， 1.013;95%可信区间[CI]， 0.979-1.049)。然而，接受101-200 mCi的患者发生第二原发恶性肿瘤的风险有统计学意义的增加(HR, 1.214;95% CI, 1.167-1.264)， 201-300 mCi (HR, 1.422;95% CI, 1.258-1.607)， bb0 - 300 mCi (HR, 1.693;95% ci, 1.545-1.854)。结论:总累积剂量为100mci或更少的RAI可以安全使用，而无需担心第二原发恶性肿瘤。然而，第二原发性恶性肿瘤的风险以剂量依赖的方式增加，需要考虑剂量超过100 mCi的RAI治疗的风险-收益。

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Second Primary Malignancy After Radioiodine Therapy in Thyroid Cancer Patient: A Nationwide Study.

Objective: This study aimed to investigate the risk of second primary malignancy after radioiodine (RAI) therapy in patients with thyroid cancer, using the National Health Insurance Service (NHIS) database.

Methods: We extracted data from the NHIS database of South Korea, which covers the entire population of the nation. Risk of second primary malignancy in the thyroid cancer patients who received RAI therapy were compared with the thyroid cancer patients who received surgery only.

Results: Between January 1, 2004, and December 31, 2018, we identified 363,155 patients who underwent thyroid surgery due to thyroid cancer for analysis. The surgery only cohort was 215,481, and the RAI cohort was 147,674 patients. A total of 19,385 patients developed second primary malignancy (solid cancer, 18,285; hematologic cancer, 1,100). There was no significant increase in the risk of second primary malignancy in patients who received a total cumulative dose of 100 mCi or less (hazard ratio [HR], 1.013; 95% confidence interval [CI], 0.979-1.049). However, a statistically significant increase in the risk of second primary malignancy was observed in patients who received 101-200 mCi (HR, 1.214; 95% CI, 1.167-1.264), 201-300 mCi (HR, 1.422; 95% CI, 1.258-1.607), and > 300 mCi (HR, 1.693; 95% CI, 1.545-1.854).

Conclusion: Total cumulative doses of 100 mCi or less of RAI can be safely administered without concerns about second primary malignancy. However, the risk of second primary malignancy increases in a dose-dependent manner, and the risk-benefit needs to be considered for doses over 100 mCi of RAI therapy.

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来源期刊

Nuclear Medicine and Molecular Imaging RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

2.20

自引率

7.70%

发文量

期刊介绍： Nuclear Medicine and Molecular Imaging (Nucl Med Mol Imaging) is an official journal of the Korean Society of Nuclear Medicine, which bimonthly publishes papers on February, April, June, August, October, and December about nuclear medicine and related sciences such as radiochemistry, radiopharmacy, dosimetry and pharmacokinetics / pharmacodynamics of radiopharmaceuticals, nuclear and molecular imaging analysis, nuclear and molecular imaging instrumentation, radiation biology and radionuclide therapy. The journal specially welcomes works of artificial intelligence applied to nuclear medicine. The journal will also welcome original works relating to molecular imaging research such as the development of molecular imaging probes, reporter imaging assays, imaging cell trafficking, imaging endo(exo)genous gene expression, and imaging signal transduction. Nucl Med Mol Imaging publishes the following types of papers: original articles, reviews, case reports, editorials, interesting images, and letters to the editor. The Korean Society of Nuclear Medicine (KSNM) KSNM is a scientific and professional organization founded in 1961 and a member of the Korean Academy of Medical Sciences of the Korean Medical Association which was established by The Medical Services Law. The aims of KSNM are the promotion of nuclear medicine and cooperation of each member. The business of KSNM includes holding academic meetings and symposia, the publication of journals and books, planning and research of promoting science and health, and training and qualification of nuclear medicine specialists.