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Efficacy of Adjuvant Radioactive Iodine Therapy in Histological Variants of DTC: A Scoping Review
Brian A Keith1,2, Evan S Chernov1,3, Shaun A Nguyen1
1Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.
Background:
The efficacy of adjuvant radioactive iodine (RAI) therapy in intermediate- and high-risk differentiated thyroid carcinoma (DTC) remains unclear, particularly for papillary thyroid carcinoma (PTC) and follicular thyroid carcinoma (FTC).
Methods:
This scoping review, following PRISMA-ScR guidelines, analyzed studies from PubMed, Scopus, and CINAHL through July 14, 2023. Data on demographics, cancer characteristics, treatment details, and clinical outcomes were extracted. A limited meta-analysis of continuous measures, proportions, and hazard ratios was performed.
Results:
Nineteen studies were included, revealing significant variability across studies. Meta-analysis was limited to overall survival (OS) in intermediate-risk PTC due to methodological heterogeneity across studies. Kaplan-Meier survival curves were inconsistent, RAI activity was often unreported, and complications of RAI were rarely addressed.
Conclusions:
Methodological heterogeneity hinders the assessment of adjuvant RAI efficacy between histological variants. Further randomized trials with extended follow-up and improved reporting are needed to better compare the effects of adjuvant RAI in PTC and FTC.
