Oncotarget

Research Papers:

Therapeutic response and long-term outcome of differentiated thyroid cancer with pulmonary metastases treated by radioiodine therapy

Jing Yang, Meng Liang, Yingying Jia, Li Wang, Lin Lin, Jianhua Geng, Shengzu Chen, Ye-Xiong Li and Rong Zheng _

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Oncotarget. 2017; 8:92715-92726. https://doi.org/10.18632/oncotarget.21570

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Abstract

Jing Yang1, Meng Liang1, Yingying Jia1, Li Wang1, Lin Lin1, Jianhua Geng1, Shengzu Chen1, Ye-Xiong Li2 and Rong Zheng1

1Department of Nuclear Medicine, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China

2Department of Radiation Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China

Correspondence to:

Rong Zheng, email: [email protected]

Keywords: thyroid cancer, pulmonary metastases, radioiodine therapy

Received: June 10, 2017     Accepted: August 28, 2017     Published: October 06, 2017

ABSTRACT

Objective: To explore the therapeutic response (TR) and long-term outcomes of iodine-131 (I-131) treatment for patients with differentiated thyroid cancer and pulmonary metastases (DTC+PM), as well as the association between the assessment of TR and long-term outcomes.

Methods: This retrospective study comprised 151 DTC+PM patients. TR was evaluated by changes in serum levels of thyroglobulin, anatomic imaging and iodine uptake in pulmonary nodules; logistic regression was applied to identify predictors. Overall survival (OS) was calculated using the Kaplan–Meier method and predictive factors of outcome by multivariate analyses.

Results: After I-131 treatment, 17 patients achieved a complete response, 71 a partial response, and 63 no response. Age, pulmonary nodule size, iodine-concentration within PM, extra-PM, frequency and cumulative dose of I-131 treatment were significant for TR. OS was 72.2% at 5, 55.2% at 10 and 51.3% at 15 years. After adjustment for other factors, age, pulmonary nodule size, extra-PM, frequency and cumulative dose of I-131 treatment were significant. A significant difference of survival rate in patients with different TR group was observed.

Conclusions: There was a supportive response and prognosis for I-131 treatment upon DTC+PM patients. Older patients and those with non-I-131-avid PM were more likely to have no response to I-131 treatment, and greater benefits could be achieved by patients who complete treatment. Long-term outcome was better in patients with age <45 years, pulmonary nodule size <2 cm, without extra-PM, and the frequency of iodine treatment ≥5 times. The predictive power of the TR on long-term prognosis was favorable.


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