Abstract

Objective: Survey the clinical characteristics of well-differentiated thyroid cancer patients with cervical lymph node metastasis as well as their response to radioactive substance iodine-131 therapy after total thyroidectomy (with/without dredging neck lymph nodes) to evaluate the effectiveness of the current treatment regimen as well as have appropriate management on each patient. Materials and methods: A retrospective, descriptive, observational study of 46 well-differentiated thyroid cancer patients with cervical lymph node metastasis who had been treated by radioactive substance iodine-131 after total thyroidectomy and were examinated at the Department of Nuclear Medicine in Hue Central Hospital from 3/2020 to early 7/2020.

Results: The age of patients ranges from under 20 to over 70 years of age, in which the age group 20-55 years old accounts for the highest proportion (84.8%). The number of female patients is greater than the number of male patients (Male/Female: 1/2.83). Papillary thyroid cancer dominates the majority of the well-differentiated thyroid cancer group (95.7%). There are 57.8% of cases with a total therapeutic dose not exceeding 200mCi, only 1 case has a total therapeutic dose above 500mCi. In this study group, 63% of patients response well to the treatment (39.1% excellent Response).

Conclusions: The group that responded well (Excellent Response; Indeterminate response) and incompletely (biochemical/structural) with the treatment are different in the total therapeutic dose, the wellresponsive group tends to have a total lower therapeutic dose (not exceeding 200mCi) and the opposite occurs to the incomplete response group. Thus, the evaluation of the patient’s conditions after 1-2 initial treatment sessions with a total therapeutic dose of 200mCi and below can help us assess the effectiveness of radioactive iodine-131 therapy for these cases, from which we can prognosticate the disease, have appropriate monitoring and treatment attitude such as changing the time of follow-up re-examination or maintaining different levels of TSH inhibition varies from patient to patient.