PSAT243 Late Versus Early Administration of Radioiodine Therapy for Patients with Differentiated Thyroid Cancer: A Systematic Review and Meta-analysis
Notice bibliographique
Résumé
Abstract Background Radioiodine (RAI) therapy is an important adjuvant therapy for differentiated thyroid carcinoma (DTC) patients. Several studies have demonstrated the efficacy of RAI in reducing the risk of thyroid cancer recurrence and mortality; however, the ideal timing to initiate RAI after surgery is debatable. This systematic review and meta-analysis evaluates the risk of achieving excellent response and mortality when comparing late administration versus early administration of RAI in patients with DTC. Methods We searched Medline, Embase, Scopus, and Cochrane Database from inception to April 2021 to identify experimental and observational studies that evaluated the impact of different timings of RAI after surgery (<3 months vs. >3 months, <6 months vs. >6 months, <9 months vs. >9 months) on the risk of excellent response and thyroid-specific mortality in DTC patients with low, intermediate, and high risk of recurrence. We used random-effects model to pool dichotomous variables with odd ratios (OR) and their confidence intervals (95%CI). The risk of bias was evaluated using the Newcastle Ottawa Scale. PROSPERO Protocol ID CRD42021267036. Results We included 12 retrospective cohort studies with 34,833 patients. The majority of participants were female (78.00%) and the mean age ranged from 39.70 (± 3.40) to 51.60 (± 1.70) years. In patients with low-to-intermediate risk of recurrence, there were no differences in excellent response (OR 0.76, 95%CI: 0.34-1.68, I2: 78.00%, n=1099) and mortality risk (OR 1.00, 95%CI: 0.84-1.19, I2: 0.00%, n=21450) in the late group (>3 months) compared to the early group (<3 months). The same outcomes were obtained for DTC patients who underwent RAI at 6 months (excellent response, OR 1.26, 95%CI: 0.94-1.69, I2: 0.00%, n=880) and at 9 months cut-offs (excellent response, OR 0.78, 95%CI: 0.32-1.91, I2: 0.00%, n=597; mortality, OR 1.28, 95%CI: 0.74-2.23, I2: 0.00%, n=327). Regarding DTC patients with high risk of recurrence, there were no differences in excellent response (OR 0.82, 95%CI: 0.61-1.11, I2: 0.00%, n=720) and mortality risk (OR 1.04, 95%CI: 0.74-1.47, I2: 62.50, n=10426) in the late group (>3 months) when compared to the early group (<3 months). Similarly for patients who underwent RAI at 6 months cut-off (excellent response, OR 1.04, 95%CI: 0.64-1.68, I2: 58.90%, n=72). However, mortality risk was higher in the late group (>6 months) when compared to the early group (<6 months) (OR 6.55, 95%CI: 2.92-14.67, I2: 0.00%, n=198). The risk of bias was considered moderate in 7 studies and high in 5. Conclusions Low-to-moderate quality of evidence suggests increased mortality with delayed RAI (>6 months) in DTC patients with high risk of recurrence. The timing of RAI for other risk categories has little or no effect. Further experimental studies are needed to confirm these results and draw robust conclusions. Presentation: Saturday, June 11, 2022 1:00 p.m. - 3:00 p.m.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,006 | 0,006 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».