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Progression-free Survival And 5-year Clinical Outcomes Post Empirical High Dose Iodine-131 (I131) Therapy In Tenis Syndrome And Mixed Disease Of Differentiated Thyroid Carcinoma

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dc.contributor.authorWAN Hussain, WAN Muhd Anas
dc.date.accessioned2026-04-15T07:41:00Z
dc.date.available2026-04-15T07:41:00Z
dc.date.issued2022-11
dc.description.abstractTitle: Progression-free survival and 5-year clinical outcomes post empirical high dose Iodine-131 (I-131) therapy in TENIS syndrome and mixed disease of differentiated thyroid carcinoma. Background: Patients with radioactive Iodine-131 (I-131) - refractory differentiated thyroid carcinoma have a poor prognosis due to limited treatment options. The limited availability and expensive tyrosine kinase inhibitor and indolent behavior differentiated thyroid cancer are the factors that drive clinicians to treat these patients empirically with high dose I-131 therapy for curative and disease control intent. Method: A retrospective cohort study of progression-free survival in patients who developed TENIS syndrome and mixed disease of differentiated thyroid carcinoma post total thyroidectomy and remnant ablation from 2010-2018. Cohort A included treatment group in which empirical high dose I-131 therapy was administered, and cohort B were those diagnosed with similar conditions but not given therapy. All patients in both cohorts were followed up for five years to look for clinical outcomes in response to treatment. Findings: Sixty-three patients were included, 46 (73%) patients developed TENIS Syndrome and 17 (27%) patients were identified as mixed disease. There were 40 patients (63.5%) who received the empirical high dose I-131 were allocated to cohort A and 23 patients (36.5%) who did not receive empirical high dose I-131 were assigned to the controlled group (cohort B). Twenty-seven patients with TENIS syndrome and 13 patients with the mixed disease were treated with empirical high dose I-131 therapy (cohort A). Empirical high dose I-131 therapy showed prolonged progression-free survival (PFS) compared to the controlled group (hazard ratio, 0.603: 95% CI, 0.308-1.179; p = 0.139) with a 40% reduction in the risk of disease progression at any given time over five years with median PFS in cohort A is at 4.7 years while cohort B is 3.6 years, though it is not statistically significant. At five years, only 20% (n=8/40) of patients in the treatment group had excellent response compared to 26% (n=6/23) in the surveillance group. However, 80% (n= 32/40; cohort A) and 83% (10/12; cohort B) remained structurally and biochemically incomplete response to therapy. Conclusion: Empirical high dose I-131 therapy prolongs progression-free survival in patients with TENIS syndrome and mixed disease. These results suggest that empirical high dose I-131 therapy represents a treatment option for these patients to prevent further disease deterioration despite statistically does not show significant results.
dc.identifier.urihttps://erepo.usm.my/handle/123456789/23927
dc.language.isoen
dc.subjectProgression-free Survival
dc.subjectTherapy In Tenis Syndrome And Mixed Disease
dc.subjectWAN Muhd Anas
dc.subjectUniversiti Sains Malaysia
dc.subjectAMDI
dc.titleProgression-free Survival And 5-year Clinical Outcomes Post Empirical High Dose Iodine-131 (I131) Therapy In Tenis Syndrome And Mixed Disease Of Differentiated Thyroid Carcinoma
dc.typeResource Types::text
dspace.entity.typePublication
oairecerif.author.affiliationUniversiti Sains Malaysia
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