Affiliation:
1. Department of Nuclear Medicine, The First Affiliated Hospital of Guangxi Medical University , Nanning 530021, China
2. Department of Pathology, The First Affiliated Hospital of Guangxi Medical University , Nanning 530021, China
3. Department of Nuclear Medicine, The Sixth Medical Center of PLA General Hospital , Beijing 100048, China
Abstract
Abstract
Objectives
To investigate the clinical character of differentiated thyroid cancer (DTC) coexisting with Hashimoto’s thyroiditis (HT) and provide state-of-art evidence for personalized radioactive iodine-131 therapy (RAIT) for patients coexisting with HT.
Methods
From January 2000 to January 2023, PubMed, Embase, and Web of Science databases were searched for relevant original articles that published in English on the RAIT efficacy for DTC with HT. RevMan 5.4 and Stata 17.0 were used for data analysis.
Results
Eleven studies involving 16 605 DTC patients (3321 with HT) were included. HT was more frequent in female (OR: 2.90, 95% confidence interval [CI]: 1.77-4.76, P < .00001). The size of tumour (MD: −0.20, 95% CI: −0.30 to −0.11), extrathyroidal extension rate (OR: 0.77, 95% CI: 0.67-0.90), and metastasis rate (OR: 0.18, 95% CI: 0.08-0.41) were less in HT, but tumour, node, metastasis (TNM) stage had no significant difference among HT and non-HT group. Disease-free survival (DFS) rate (OR: 1.96, 95% CI: 1.57-2.44, P < .00001), 5-year DFS (OR: 1.73, 95% CI: 1.04-2.89, P = .04), and 10-year DFS (OR: 1.56, 95% CI: 1.17-2.09, P = .003) were higher in HT group. The recurrent (OR: 0.62, 95% CI: 0.45-0.83, P = .002), RAIT dosage (MD = −38.71, 95% CI: −60.86 to −16.56, P = .0006), and treatment (MD: −0.13, 95% CI: −0.22 to −0.03, P = .008) were less in HT group.
Conclusions
DTC coexisting with HT was associated with less invasion. DFS of HT group was higher than non-HT group after RAIT. Low-dose treatment did not impair the efficacy of RAIT in DTC with HT.
Advances in knowledge
Hashimoto’s thyroiditis is a risk for DTC, but it minimalizes the progression of cancer and enhance the efficacy of RAIT, which should be considered in personalizing RAIT.
Funder
Innovation Project of Guangxi Graduate Education
Publisher
Oxford University Press (OUP)