ĐẶC ĐIỂM LÂM SÀNG VÀ KẾT QUẢ ĐIỀU TRỊ I-131 Ở BỆNH NHÂN UNG THƯ TUYẾN GIÁP THỂ BIỆT HÓA DI CĂN PHỔI

Abstract

Objective: This study aims to investigate clinical characteristics of differentiated thyroid carcinoma (DTC) patients with lung metastasis and the effectiveness of ¹³¹I therapy  Subjects and Methods: This is a retrospective, descriptive cross-sectional study on 294 patients with differentiated thyroid cancer (DTC) with lung metastasis who underwent total thyroidectomy and were treated with I-131 from 2005 to 2024, at the Department of Nuclear Medicine – 108 Military Central Hospital. The Kaplan-Meier curve was used to estimate overall survival (OS). Results: The average age at the time of lung metastasis diagnosis was 37.95 ± 16.22 (ranging from 7 to 73 years), with 78.2% of patients being under 55 years old. The female-to-male ratio was 2.5:1. Papillary carcinoma accounted for 93.2%. On average, patients underwent 5.83 I-131 treatments, with a cumulative dose of 809.4 ± 371.26 mCi. The proportion of patients with isolated lung metastasis was 12.5%, while lung metastasis combined with regional lymph node, bone, and other distant sites metastasis was 75.8%, 7.4%, and 4.3%, respectively. The rates of complete response, incomplete response, and indeterminate response according to ATA-2015 classification were 6.5%, 81.6%, and 11.9%, respectively. The overall survival rates at 5, 10, and 15 years were 96.3%, 87.9%, and 74.2%, respectively. OS in patients with lung metastasis accompanied by other distant metastases was significantly lower compared to those with only isolated lung metastasis and those with lung metastasis combined with regional cervical lymph node metastasis (p < 0.001).