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Analysis of radioiodine therapy and prognostic factors of differentiated thyroid cancer patients with pulmonary metastasis: An 8-year retrospective study.

Abstract To assess the efficacy of radioiodine therapy (RIT) and investigate the prognostic factors for patients with pulmonary metastasis secondary to differentiated thyroid carcinoma (DTC) through a retrospective study. A total of 80 patients with radioactive iodine-131 (I)-avid pulmonary metastasis from DTC treated with I from 2007 to 2014 at our institution entered the study. Treatment response was mainly measured by two parameters: serum thyroglobulin (Tg) levels and post-therapeutic I whole-body scan (WBS). Treatment variables were assessed for statistical significance using the univariate and multivariate analyses. A receiver-operating characteristic (ROC) curve was also plotted to verify the accuracy of predictors. Of these 80 patients, the overall effective rate was 72.5% (58/80), the rates for complete response (CR), partial response (PR), and no response (NR) were 20.0%, 52.5%, and 27.5%, respectively. Univariate analysis showed that gender, pulmonary nodule size, absence or presence of extrapulmonary distant metastases, age, and Tg level at diagnosis were significantly associated with I therapy efficacy. Binary logistic regression analysis revealed that older patients (odds ratio [OR]:1.481, 95% confidence interval [CI]: 1.457-2.091, P = .020), subjects with higher Tg levels at diagnosis (OR: 1.046, 95% CI: 1.016-1.119, P = .014), and those with extrapulmonary distant metastases (OR: 1.185, 95%CI: 1.025-1.463, P = .020) had a higher probability of poor prognosis. The optimal cutoffs for age and Tg level to predict I therapy efficacy for DTC with lung metastases were 46 years old and 55.50 ng/mL, respectively, based on ROC analysis. This study indicated that most DTC patients with pulmonary metastases can obtain partial or complete remission after RIT, while older patients with higher Tg levels at diagnosis and extrapulmonary distant metastases more likely show poor prognosis.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 28489758
OWN - NLM
STAT- MEDLINE
DA  - 20170510
DCOM- 20170612
LR  - 20170612
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 19
DP  - 2017 May
TI  - Analysis of radioiodine therapy and prognostic factors of differentiated thyroid 
      cancer patients with pulmonary metastasis: An 8-year retrospective study.
PG  - e6809
LID - 10.1097/MD.0000000000006809 [doi]
AB  - To assess the efficacy of radioiodine therapy (RIT) and investigate the
      prognostic factors for patients with pulmonary metastasis secondary to
      differentiated thyroid carcinoma (DTC) through a retrospective study. A total of 
      80 patients with radioactive iodine-131 (I)-avid pulmonary metastasis from DTC
      treated with I from 2007 to 2014 at our institution entered the study. Treatment 
      response was mainly measured by two parameters: serum thyroglobulin (Tg) levels
      and post-therapeutic I whole-body scan (WBS). Treatment variables were assessed
      for statistical significance using the univariate and multivariate analyses. A
      receiver-operating characteristic (ROC) curve was also plotted to verify the
      accuracy of predictors. Of these 80 patients, the overall effective rate was
      72.5% (58/80), the rates for complete response (CR), partial response (PR), and
      no response (NR) were 20.0%, 52.5%, and 27.5%, respectively. Univariate analysis 
      showed that gender, pulmonary nodule size, absence or presence of extrapulmonary 
      distant metastases, age, and Tg level at diagnosis were significantly associated 
      with I therapy efficacy. Binary logistic regression analysis revealed that older 
      patients (odds ratio [OR]:1.481, 95% confidence interval [CI]: 1.457-2.091, P =
      .020), subjects with higher Tg levels at diagnosis (OR: 1.046, 95% CI:
      1.016-1.119, P = .014), and those with extrapulmonary distant metastases (OR:
      1.185, 95%CI: 1.025-1.463, P = .020) had a higher probability of poor prognosis. 
      The optimal cutoffs for age and Tg level to predict I therapy efficacy for DTC
      with lung metastases were 46 years old and 55.50 ng/mL, respectively, based on
      ROC analysis. This study indicated that most DTC patients with pulmonary
      metastases can obtain partial or complete remission after RIT, while older
      patients with higher Tg levels at diagnosis and extrapulmonary distant metastases
      more likely show poor prognosis.
FAU - Wang, Renfei
AU  - Wang R
AD  - Department of Nuclear Medicine, Tianjin Medical University General Hospital,
      Anshan Road, Tianjin, People's Republic of China.
FAU - Zhang, Yueqian
AU  - Zhang Y
FAU - Tan, Jian
AU  - Tan J
FAU - Zhang, Guizhi
AU  - Zhang G
FAU - Zhang, Ruiguo
AU  - Zhang R
FAU - Zheng, Wei
AU  - Zheng W
FAU - He, Yajing
AU  - He Y
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Biomarkers, Tumor)
RN  - 0 (Iodine Radioisotopes)
RN  - 9010-34-8 (Thyroglobulin)
SB  - AIM
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Biomarkers, Tumor/blood
MH  - Carcinoma/blood/diagnosis/*pathology/*radiotherapy
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Iodine Radioisotopes/therapeutic use
MH  - Lung Neoplasms/blood/diagnosis/*radiotherapy/*secondary
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - ROC Curve
MH  - Retrospective Studies
MH  - Thyroglobulin/blood
MH  - Thyroid Neoplasms/blood/diagnosis/*pathology/*radiotherapy
MH  - Treatment Outcome
MH  - Whole Body Imaging
MH  - Young Adult
PMC - PMC5428592
EDAT- 2017/05/11 06:00
MHDA- 2017/06/13 06:00
CRDT- 2017/05/11 06:00
AID - 10.1097/MD.0000000000006809 [doi]
AID - 00005792-201705120-00025 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 May;96(19):e6809. doi: 10.1097/MD.0000000000006809.

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