Factors influencing postoperative anxiety and depression following Iodine-131 treatment in patients with differentiated thyroid cancer:A cross-sectional study

BACKGROUND Differentiated thyroid cancer(DTC)often seriously impacts patients’lives.Radionuclide Iodine-131(131I)is widely used in treating patients with DTC.However,most patients know little about radionuclide therapy,and the treatment needs to be performed in a special isolation ward,which can cause anxiety and depression.AIM To explore anxiety and depression status and their influencing factors after 131I treatment in patients with DTC.METHODS A questionnaire survey was conducted among postoperative patients with DTC who received 131I treatment at our hospital from June 2020 to December 2022.General patient data were collected using a self-administered demographic characteristics questionnaire.The self-rating depression scale and self-rating anxiety scale were used to determine whether patients were worried about their symptoms and the degree of anxiety and depression.The patients were categorized into anxiety,non-anxiety,depression,and non-depression groups.Singlevariable and multiple-variable analyses were used to determine the risk factors for anxiety and depression in patients with thyroid cancer after surgery.RESULTS A total of 144 patients were included in this study.The baseline mean score of self-rating anxiety and depression scales were 50.06±16.10 and 50.96±16.55,respectively.Notably,48.62%(70/144)had anxiety and 47.22%(68/144)of the patients had depression.Sex,age,education level,marital status,household income,underlying diseases,and medication compliance significantly differed among groups(P<0.05).Furthermore,multivariate logistic regression analysis showed that education level,per capita monthly household income,and medication compliance level affected anxiety(P=0.015,0.001,and 0.001 respectively).Patient’s sex,marital status,and underlying diseases affected depression(P=0.007,0.001,and 0.009,respectively).CONCLUSION Nursing interventions aiming at reducing the risk of anxiety and depression should target unmarried female patients with low education level,low family income,underlying diseases,and poor adherence to medications.

^(131)I treatment for brain metastases from differentiated thyroid carcinoma

To assess the clinical value of treatment with 131I for brain metastases from differentiated thyroid cancer (DTC), we have observed 8 cases of brain metastases from DTC who received follow-up after 131I therapy (2male, 6 female, aged 12～65 years). The results of 131I therapy were evaluated with clinical presentation, imaging scan and survival analysis. The main results are as follows. (1) All cases had been survival for 2～35 years in follow-up. (2)A space-occupying lesion in right cerebellum was reduced after taking 20.65 GBq and disappeared after 23.61 GBq,demonstrated by computed tomography. (3) The sequences and doses of 131I therapy were clearly decreased for the cases with total thyroidectomy in comparison with those with semithyroidectomy (p＜0.01). (4) The brain metastases with lung and/or bone metastasis from DTC were 75% (6/8) and it was difficult to cure these metastases at the same time. It is concluded that the postoperative treatment of 131I for brain metastases from DTC after undergoing thyroidectomy may improve clinical symptoms and life quality, reduce lesions, and prolong survival.

^(131)I治疗分化型甲状腺癌脑转移

目的 探讨1 31 I治疗分化型甲状腺癌 (DTC)脑转移的临床价值。方法 随访 8例经1 31 I治疗的DTC脑转移患者 ,通过临床症状、影像学检查及生存率分析 ,观察DTC脑转移1 31 I治疗效果。结果 ①1 31 I治疗后生存期 2～ 3 5年 ,2 0 0 1年底随访时均存活。② 1例患者1 31 I治疗 5次 ( 2 0 .65GBq)后CT示右小脑占位灶缩小 ,6次 ( 2 3 .61GBq)后CT示占位灶消失。③甲状腺双侧切除者 ,术后剩余甲状腺平均1 31 I清除次数为 2次 ,平均总清除剂量 8.87GBq ;单侧切除者 ,平均清除次数 5 .7次 ,平均总清除剂量 2 9.98GBq ,后者的清除次数和剂量均明显高于前者 (P <0 .0 1)。④合并有肺和 (或 )骨转移者 6例。1 31 I治疗后 1例脑转移灶消失 ,但肺转移灶仍有1 31 I摄取 ;1例治疗后1 31 I肺显像阴性 ,但脑和骨转移灶仍见1 31 I摄取。结论 合并有肺和 (或 )骨转移的DTC脑转移者治疗难度增加 ,但术后1 31

I^(131)治疗分化型甲状腺癌骨转移疗效观察

目的:分析I131治疗分化型甲状腺癌骨转移的治疗效果。方法:回顾性分析32例接受I131治疗的分化型甲状腺癌骨转移患者,其中14例骨转移灶在I131治疗前接受手术治疗。结果:24例骨转移伴有疼痛,I131治疗止痛有效率(完全缓解和部分缓解)为88%,其中完全缓解率为50%,部分缓解率为38%。18例接受单纯I131治疗,无1例骨病灶完全消除,而手术加I131治疗的14例中,9例骨病灶完全消除者均为单发骨转移灶。结论:I131是治疗分化型甲状腺癌骨转移的有效治疗手段,能缓解骨疼痛,并对部分骨转移灶有消除作用。手术合并I131治疗分化型甲状腺癌局限的骨转移灶可以有效的消除病灶,建议对局限性骨转移灶进行手术加I131综合治疗。