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Meta-Analysis
. 2018 Jul;20(7):928-935.
doi: 10.1007/s12094-017-1792-1. Epub 2017 Nov 8.

Efficacy of radioiodine therapy for treating 20 patients with pulmonary metastases from differentiated thyroid cancer and a meta-analysis of the current literature

X Zhang  1 , D-S Liu  1 , Z-S Luan  2 , F Zhang  1 , X-H Liu  1 , W Zhou  2 , S-F Zhong  2 , H Lai  3
Affiliations
Meta-Analysis

Efficacy of radioiodine therapy for treating 20 patients with pulmonary metastases from differentiated thyroid cancer and a meta-analysis of the current literature

X Zhang et al. Clin Transl Oncol. 2018 Jul.

Abstract

Background: Radioiodine therapy (RAI) after total or near-total thyroidectomy is a recommended treatment for patients with pulmonary metastasis from differentiated thyroid cancer (DTC). However, the total effective rate of iodine-131 therapy remains controversial. This study aimed to determine the efficacy of RAI for treating patients with pulmonary metastasis from DTC, and to identify independent predictors of its efficacy.

Methods: We conducted a retrospective study to evaluate 20 patients with pulmonary metastasis from DTC who underwent RAI at our center at first and performed a meta-analysis to evaluate relevant literature regarding the overall efficacy of RAI and subgroup-specific efficacies subsequently.

Results: The efficacy rate at our center was 40%, and no significant differences were observed according to sex, age, pathological type, metastasis state, or interval between the initial RAI and final surgery. The meta-analysis revealed that the pooled overall efficacy rate was 58%, and significant differences were observed when we compared pulmonary metastasis versus pulmonary and other distant metastasis, age of < 40 years versus age of ≥ 40 years, papillary thyroid cancer versus follicular thyroid cancer and male patients versus female patients.

Conclusions: These results suggest that RAI is an effective treatment for patients with pulmonary metastasis from DTC after surgical treatment. The efficacy of RAI was significantly predicted by the presence of papillary thyroid cancer, age of < 40 years, the absence of non-lung distant metastasis and female patients.

Keywords: Differentiated thyroid cancer; Efficacy; Meta-analysis; Pulmonary metastasis; Radioiodine therapy.

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Conflict of interest statement

Conflict of interest

No conflict of interest exits regarding the submission of this manuscript.

Research involving human

All the patients in this retrospective study came from the Department of Nuclear Medicine, the 88th PLA Hospital. The study complied with ethical standards and informed consent statement is not necessary for retrospective study.

Figures

Fig. 1
Fig. 1
The article selection procedure
Fig. 2
Fig. 2
Forest plots for the pooled overall efficacy rate using a fixed-effects model
Fig. 3
Fig. 3
Forest plots comparing the efficacy rates in the PM and PODM groups using a fixed-effects model. PM pulmonary metastasis, PODM pulmonary and other distant metastasis
Fig. 4
Fig. 4
Forest plots comparing the efficacy rates in the AL and ANL groups using a fixed-effects model. AL age of < 40 years, ANL age of ≥ 40 years
Fig. 5
Fig. 5
Forest plots comparing the efficacy rates in the PTC and FTC groups using a fixed-effects model. PTC papillary thyroid cancer, FTC follicular thyroid cancer
Fig. 6
Fig. 6
Forest plots comparing the efficacy rates among men and women using a fixed-effects model
Fig. 7
Fig. 7
Forest plots comparing the efficacy rates which correlated most closely with ours in the PM and PODM groups using a fixed-effects model. PM pulmonary metastasis, PODM pulmonary and other distant metastasis
Fig. 8
Fig. 8
Forest plots comparing the efficacy rates which correlated most closely with ours in the PTC and FTC groups using a fixed-effects model. PTC papillary thyroid cancer, FTC follicular thyroid cancer
Fig. 9
Fig. 9
Forest plots comparing the efficacy rates which correlated most closely to ours among men and women using a fixed-effects model
Fig. 10
Fig. 10
Funnel plot for the included reports. RD risk difference, SE standard error
See this image and copyright information in PMC

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