Differentiated Thyroid Cancer: Changes In The Pulmonary Function Test Post First Radioactive Iodine Treatment
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Date
2019
Authors
Nor Qistin Muhamad
Journal Title
Journal ISSN
Volume Title
Publisher
Universiti Sains Malaysia
Abstract
Title: Differentiated Thyroid Cancer: Changes in The Pulmonary Function Test
Post First Radioactive Iodine Treatment
Introduction: A thyroid disease could be benign or malignant. Management of thyroid
disease has been well established and documented following the American Thyroid
Association Guidelines. Radioactive Iodine (RAI) or Iodine-131 (131I) is used to treat
differentiated thyroid cancer and benign hyperthyroidism. Radiation pneumonitis and lung
fibrosis are lungs complication beside other complication after the exposure of Iodine-131.
Differentiated Thyroid Cancer (DTC) patients have longer survival rate as compared to
other solid tumour even if the patients had distant metastasis at first diagnosis. Thus,
having good lung function is essential for the survival and quality of life. Recent study
showed that lung function of some patients with lung metastasis has been found severely
impaired during follow-ups.
Objective: The aim is to evaluate changes of pulmonary function in DTC patients after
exposure to first Iodine-131 treatment and to look for differences between patients with or
without lung metastasis
Methods: Post total or near total thyroidectomy differentiated thyroid cancer patients
referred for first Iodine-131 treatment were evaluated and recruited as study subjects. These
patients had the pulmonary function test (PFT) before the first Iodine-131 treatment started. Repeated PFT was performed at 3 and 6 months after the first Iodine-131 treatment.
Clinical data was analysed using IBMM SPSS software.
Results: A total of 49 patients with the median and mean age of 40’s were recruited
and the majority were females (88%) and by ethnicity, the majority were Malay which was
about 65%. 8 patients had metastasis whereby 2 were diagnosed based on computed
tomography (CT) findings during pre- Iodine-131 ablation and the rest based on post
Iodine-131 treatment whole body scan. 24 patients had normal baseline PFT. The median
value of baseline PFT was forced vital capacity (FVC)=79%, forced expiratory volume in 1
second (FEV1)=84% and FEV1/FVC=88. There were no significant changes of FVC,
FEV1 and FEV1/FVC after 3 and 6 months of Iodine-131 ablation (p=0.985, p=1.0 and
p=0.58 respectively). There were also no significant changes of PFT for patients with
normal or abnormal baseline as well as for patients with or without lung metastasis.
Conclusion: There was no significant worsening of pulmonary function test in the
differentiated thyroid cancer patients after their first radioactive iodine treatment even for
patients with abnormal baseline or patients with lung metastasis.
Keyword: Thyroid cancer, Nuclear Medicine, Radionuclide imaging, Radioactive
Iodine Therapy, Pulmonary function test
Description
Keywords
Thyroid Neoplasms