Evidence map›Paper›PMID 40414995›Full record

ArticleEuropean journal of nuclear medicine and molecular imaging2025

Less is more: once vs. multiple radioactive iodine (RAI) therapy in patients with RAI-avid pulmonary micrometastatic differentiated thyroid cancer.

Cong Shi, Di Sun, Yu-Qing Sun, Xin Zhang, Sheng-Yan Liu, Qi-Jun Li, Yi-Jin Pan, Wen-Ting Guo, Ying-Qiang Zhang, Xiao-Na Jin and 2 more

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in European journal of nuclear medicine and molecular imaging, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Cong ShiDepartment of Nuclear Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
Di SunDepartment of Nuclear Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
Yu-Qing SunDepartment of Nuclear Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
Xin ZhangDepartment of Nuclear Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
Sheng-Yan LiuDepartment of Nuclear Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
Qi-Jun LiDepartment of Nuclear Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
Yi-Jin PanDepartment of Nuclear Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
Wen-Ting GuoBiomedical Engineering Facility of National Infrastructures for Translational Medicine, Institute of Clinical Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
Ying-Qiang ZhangDepartment of Nuclear Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
Xiao-Na JinDepartment of Nuclear Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
Yu LiuDepartment of Nuclear Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
Yan-Song LinDepartment of Nuclear Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China. linyansong1968@163.com.ORCID 0000-0001-6095-4728

Funding

National High Level Hospital Clinical Research Funding No. 2022-PUMCH-B-072
6 · The paper itself

Abstract

purposeTo date, the survival benefits of multiple radioactive iodine therapies (RAIT) in RAI-avid pulmonary micrometastatic differentiated thyroid cancer (DTC) remain debatable. This study aimed to compare the progression-free survival (PFS) benefits between those received only once RAIT (o-RAIT) and multiple RAITs (m-RAIT) in such patients.

methodsPatients with RAI-avid pulmonary micrometastatic DTC were included and divided into either o-RAIT or m-RAIT group according to the number of RAIT cycles. The response to first RAIT in all patients and last RAIT in m-RAIT were evaluated and classified as partial response (PR), stable disease (SD), and progressive disease (PD). PFS was defined as the time from first RAIT to PD. Logistic regression analysis and Kaplan-Meier survival curves were employed to identify risk factors and estimate PFS, with propensity score matching (PSM) to reduce confounders.

resultsA total of 117 patients with RAI-avid pulmonary micrometastatic DTC were retrospectively included, with 38 (32.5%) from o-RAIT and 79 (67.5%) from m-RAIT. Patients from m-RAIT exhibited younger age at diagnosis, more local persistent disease before RAIT, and more metachronous metastasis compared with o-RAIT group (all P < 0.05). In the comparison of RAIT response, there was no difference in the first RAIT response between the o-RAIT and m-RAIT, while the last RAIT response of m-RAIT is worse not only than o-RAIT (P = 0.005), but also than their own first RAIT response (P = 0.0003). Multivariate analysis revealed age at diagnosis (over 45 years old) (P = 0.006) and local persistent disease before RAIT (P = 0.001) were independent risk factors for PD after RAIT, while number of RAIT cycles was not. To minimize potential confounders, the risk factors for PD and follow-up time were matched by PSM, after which, no significant difference in PFS was observed between the matched o-RAIT and m-RAIT (5-year PFS rate: 83.6% vs. 81.6%, P = 0.808).

conclusionsIn patients with RAI-avid pulmonary micrometastatic DTC, o-RAIT exhibited non-inferior PFS benefits compared with m-RAIT, suggesting the "less is more" management strategy of RAIT towards such patients.

Indexed as

Iodine RadioisotopesLung NeoplasmsThyroid NeoplasmsAdultAgedFemaleHumansMaleMiddle AgedNeoplasm MicrometastasisRetrospective StudiesTreatment OutcomeIodine RadioisotopesDifferentiated thyroid cancerProgression-free survivalPropensity score matchingPulmonary micrometastasisRadioactive iodine-avid lesion

Identifiers

PMID40414995

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