Is radioiodine necessary for patients with low-risk differentiated thyroid cancer after thyroidectomy: a pooled analysis of ESTIMABL2 and IoN trials.
[BACKGROUND] The clinical utility of postoperative radioiodine therapy in patients with low-risk differentiated thyroid cancer (DTC) remains a subject of ongoing debate.
- HR 0.96
- RR 0.78
- 연구 설계 meta-analysis
APA
Yang C, Luo D, et al. (2025). Is radioiodine necessary for patients with low-risk differentiated thyroid cancer after thyroidectomy: a pooled analysis of ESTIMABL2 and IoN trials.. Frontiers in oncology, 15, 1670978. https://doi.org/10.3389/fonc.2025.1670978
MLA
Yang C, et al.. "Is radioiodine necessary for patients with low-risk differentiated thyroid cancer after thyroidectomy: a pooled analysis of ESTIMABL2 and IoN trials.." Frontiers in oncology, vol. 15, 2025, pp. 1670978.
PMID
41229489
Abstract
[BACKGROUND] The clinical utility of postoperative radioiodine therapy in patients with low-risk differentiated thyroid cancer (DTC) remains a subject of ongoing debate. Although radioiodine has been widely employed to reduce the risk of recurrence, its necessity in low-risk populations is increasingly questioned, given the favorable outcomes observed with surgery alone. To address this issue, we conducted a meta-analysis exclusively based on randomized controlled trials (RCTs) to comprehensively evaluate the efficacy and safety of radioiodine therapy in this specific patient population.
[METHODS] We systematically searched 6 databases for eligible phase 3 RCTs comparing surgery with or without radioiodine in patients with low-risk DTC. Primary outcomes included recurrence and recurrence-free survival (RFS); secondary outcomes included adverse events (AEs), structural events, and biological events. Risk ratios (RRs) or hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled and analyzed.
[RESULTS] Two phase 3 RCTs (the ESTIMABL2 and IoN trials), encompassing 1280 patients, were included. Compared to the non-radioiodine group, radioiodine therapy did not significantly reduce recurrence rates (RR: 0.78 [0.36-1.70], = 0.53) or improve RFS (HR: 0.96 [0.80-1.15], = 0.68). The total number of structural events (RR: 0.83 [0.68-1.02], = 0.07) and biological events (RR: 0.88 [0.71-1.08], = 0.23) were also similar between the two groups. In the safety analysis, the two groups exhibited comparable rates of AEs (RR: 0.97 [0.79-1.20], = 0.80), grade 3-5 AEs (RR: 0.25 [0.03-2.20], = 0.21), death (RR: 1.28 [0.48-3.41], = 0.62), and second primary cancers (RR: 1.26 [0.58-2.73], = 0.55).
[CONCLUSION] Radioiodine therapy did not confer significant benefits in reducing recurrence or improving RFS in patients with low-risk DTC after thyroidectomy, and the safety profiles were comparable between the two groups.
[SYSTEMATIC REVIEW REGISTRATION] https://www.crd.york.ac.uk/prospero/, identifier CRD420251105509.
[METHODS] We systematically searched 6 databases for eligible phase 3 RCTs comparing surgery with or without radioiodine in patients with low-risk DTC. Primary outcomes included recurrence and recurrence-free survival (RFS); secondary outcomes included adverse events (AEs), structural events, and biological events. Risk ratios (RRs) or hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled and analyzed.
[RESULTS] Two phase 3 RCTs (the ESTIMABL2 and IoN trials), encompassing 1280 patients, were included. Compared to the non-radioiodine group, radioiodine therapy did not significantly reduce recurrence rates (RR: 0.78 [0.36-1.70], = 0.53) or improve RFS (HR: 0.96 [0.80-1.15], = 0.68). The total number of structural events (RR: 0.83 [0.68-1.02], = 0.07) and biological events (RR: 0.88 [0.71-1.08], = 0.23) were also similar between the two groups. In the safety analysis, the two groups exhibited comparable rates of AEs (RR: 0.97 [0.79-1.20], = 0.80), grade 3-5 AEs (RR: 0.25 [0.03-2.20], = 0.21), death (RR: 1.28 [0.48-3.41], = 0.62), and second primary cancers (RR: 1.26 [0.58-2.73], = 0.55).
[CONCLUSION] Radioiodine therapy did not confer significant benefits in reducing recurrence or improving RFS in patients with low-risk DTC after thyroidectomy, and the safety profiles were comparable between the two groups.
[SYSTEMATIC REVIEW REGISTRATION] https://www.crd.york.ac.uk/prospero/, identifier CRD420251105509.
같은 제1저자의 인용 많은 논문 (5)
- Estimating major pathological response in non-small cell lung cancer patients with post-neoadjuvant therapy using MMT-net.
- Long-term fine particulate air pollution exposure and risk of gastric cancer mortality in Taiwan.
- A trispecific antibody engaging T cells with tumour and myeloid cells augments antitumour immunity.
- Lactylation as a metabolic-epigenetic switch in cancer: dual roles in cell death resistance and therapeutic vulnerability.
- Development of a machine learning model for preoperative prediction of spread through air spaces in resectable non-small cell lung cancer: A single-center retrospective study.