NHẬN XÉT ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG VÀ KẾT QUẢ ĐIỀU TRỊ UNG THƯ TUYẾN GIÁP THỂ BIỆT HÓA KHÁNG I – 131 TẠI BỆNH VIỆN K.

Abstract

Introduction:
Thyroid carcinoma, specifically differentiated thyroid carcinoma (DTC), poses a significant clinical challenge. This study aims to assess the clinical and subclinical features and outcomes of Radioiodine Refractory Differentiated Thyroid Carcinoma. The research was conducted at Hospital K from January 2020 to October 2023.
Methods:
Radioiodine Refractory Differentiated Thyroid Carcinoma Patients were included in the study. These had undergone total thyroidectomy, neck lymph node dissection, and subsequent I-131 therapy. The study followed a retrospective and prospective approach, with continuous monitoring over the specified period.
Results:
A total of 146 Radioiodine Refractory Differentiated Thyroid Carcinoma Patients were included in this study. The average age was 50.26 years (±15.5), with a female-to-male ratio of 3:1. Histopathological analysis revealed that 70.4% had follicular thyroid carcinoma, 25.9% had papillary thyroid carcinoma, and the remaining 3.7% had a combination of both. Staging of the disease indicated that 44.4% of patients were in Stage I, 18.5% in Stage II, 3.7% in Stage III, and 18.5% in Stage IV. The average I-131 treatment dose until the development of resistance was 396.2 mCi (±156.7). Based on the Response Evaluation Criteria in Solid Tumors (RECIST) classification, 51.9% of patients belonged to Group I, 25.9% to Group II, 18.5% to Group III, and 3.7% to Group IV. The most common sites of metastasis were cervical lymph nodes (40.7%), followed by the lungs (18.5%), while other sites were less frequent and often presented concurrently with cervical lymph node metastasis. Surgical resection of distant metastases was performed in 14.8% of patients, 33.3% continued I-131 treatment, 37% received no further treatment and underwent TSH suppression therapy, and the remaining 7.4% of patients underwent external beam radiotherapy and targeted therapy with Levatinib.
Discussion:
This study sheds light on the clinical characteristics and outcomes of Radioiodine Refractory Differentiated Thyroid Carcinoma Patients. These findings contribute to a better understanding of the disease and inform future treatment strategies for this challenging patient population.