방사선의학 웹진

바로가기  >

Abstract
Purpose: Risk of second primary malignancy (SPM) after radioiodine (RAI) therapy has been continuously debated. The aim of this study is to identify the risk of SPM in thyroid cancer (TC) patients with RAI compared with TC patients without RAI from matched cohort.

Methods: Retrospective propensity-matched cohorts were constructed across 4 hospitals in South Korea via the Observational Health Data Science and Informatics (OHDSI), and electrical health records were converted to data of common data model. TC patients who received RAI therapy constituted the target group, whereas TC patients without RAI therapy constituted the comparative group with 1:1 propensity score matching. Hazard ratio (HR) by Cox proportional hazard model was used to estimate the risk of SPM, and meta-analysis was performed to pool the HRs.

Results: Among a total of 24,318 patients, 5,374 patients from each group were analyzed (mean age 48.9 and 49.2, women 79.4% and 79.5% for target and comparative group, respectively). All hazard ratios of SPM in TC patients with RAI therapy were ≤ 1 based on 95% confidence interval(CI) from full or subgroup analyses according to thyroid cancer stage, time-at-risk period, SPM subtype (hematologic or non-hematologic), and initial age (< 30 years or ≥ 30 years). The HR within the target group was not significantly higher (< 1) in patients who received over 3.7 GBq of I-131 compared with patients who received less than 3.7 GBq of I-131 based on 95% CI.

Conclusion: There was no significant difference of the SPM risk between TC patients treated with I-131 and propensity-matched TC patients without I-131 therapy.

Affiliations

Seok Kim #  1 , Ji-In Bang #  2 , Dachung Boo  1 , Borham Kim  1 , In Young Choi  3 , SooJeong Ko  3   4 , Ie Ryung Yoo  5 , Kwangsoo Kim  6   7 , Junmo Kim  8 , YoungHwan Joo  9 , Hyun Gee Ryoo  10 , Jin Chul Paeng  11 , Jung Mi Park  12 , Woncheol Jang  13 , Byungwon Kim  14 , Yangha Chung  13 , Dongyoon Yang  13 , Sooyoung Yoo  15 , Ho-Young Lee  16
1 Office of eHealth Research and Business, Seoul National University Bundang Hospital, 173rd Street, Gumi-ro, Seongnam-si 436-707, Republic of Korea.
2 Department of Nuclear Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea.
3 Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
4 Department of Biomedicine & Health Sciences, The Catholic University of Korea, Seoul, Republic of Korea.
5 Division of Nuclear Medicine, Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
6 Transdisciplinary Department of Medicine & Advanced Technology, Seoul National University Hospital, Seoul, Republic of Korea.
7 Medical Big Data Research Center, Seoul National University Medical Research Center, Seoul, Republic of Korea.
8 Interdisciplinary Program in Bioengineering, Seoul National University, Seoul, Republic of Korea.
9 Biomedical Research Institute, Seoul National University Hospital, Seoul, South Korea.
10 Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
11 Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
12 Department of Nuclear Medicine, Soonchunhyang University Bucheon Hospital, Gyeonggido, Republic of Korea.
13 Department of Statistics, Seoul National University, Seoul, South Korea.
14 Department of Statistics, Kyungpook National University, Daegu, South Korea.
15 Office of eHealth Research and Business, Seoul National University Bundang Hospital, 173rd Street, Gumi-ro, Seongnam-si 436-707, Republic of Korea. yoosoo0@snubh.org.
16 Department of Nuclear Medicine, Office of eHealth Research and Business, Seoul National University Bundang Hospital, 166, Gumi-ro, Seongnam-si 436-707, Republic of Korea. debobkr@snubh.org.
# Contributed equally.