A meta-analysis of efficacy of iodine-131 for post-thyroidectomy ablation of remnants in patients with differentiated thyroid carcinoma

Abstract

Objective To assess the effects of two different doses of 131I（3700 MBq vs. 1110 MBq） for ablation of thyroid remnant in patients with differentiated thyroid carcinoma （ DTC ） by using meta analysis. Methods Collected the eligible trials by searching the Cochrane Library, MEDLINE, OVID, EMBASE, EBSCO and SpringerLink from January 1980 to August 2013. All relevant studies were screened according to inclusion and exclusion criteria. A modified Jadad scale was used for quality evaluation of se-lected literatures. RveMan 5.1 software was used for statistical analysis. Results Twelve randomized con-trolled trails involving 2290 patients were included in accordance with the inclusion and exclusion criteria. According to the criteria of successful thyroid remnant ablation reported in each literature, no statistical difference was noted in the rate of successful remnant ablation between low-and high-dose 131I group （Z=1.80, P〉0.05）. Both the low- or high-dose of 131I ablation showed no significant difference in the rate of successful remnant ablation between the two methods （recombinant human thyrotropin vs. steroid with-drawal） of preparing therapy（Z=0.98 and 0.33, P〉0.05）. Also, no significant differences existed in qual-ity-of-life scores on the SF-36 between different 131I-dose groups （Z=0.37, P〉0.05）. The low-dose group showed lower incidence of adverse events（Z=5.15, P〈0.01） and shorter hospital isolation time than that in high-dose 131I group. Conclusions Two different doses of 131I treatment and two different preparation methods have similar efficacy in ablation of residual thyroid tissue in patients with low risk DTC, but the＆amp;nbsp;incidence of adverse effects in low-dose 131I group is less. Key words: Thyroid neoplasms; Iodine radioisotopes; Meta-analysis; Randomized controlled trials