Construction and application of a competitive risk model for 131I treatment outcome of Graves disease
10.3760/cma.j.cn321828-20210806-00266
- VernacularTitle:格雷夫斯病 131I治疗结局竞争风险模型的构建与应用
- Author:
Liwei HONG
1
;
Shuping YANG
;
Yuegui WANG
;
Xuepeng HUANG
;
Lixia HUANG
;
Tingting LI
;
Keyue CHEN
;
Haolin SHEN
Author Information
1. 福建医科大学附属漳州市医院核医学科 363005
- Keywords:
Graves disease;
Radiotherapy;
Iodine radioisotopes;
Forecasting;
Nomograms
- From:
Chinese Journal of Nuclear Medicine and Molecular Imaging
2021;41(12):732-736
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To establish a competing risk model to predict the cumulative hazard risk probability of the outcomes (unhealed or hyperthyroidism recurrence) of Graves disease (GD) treated with 131I. Methods:From January 2020 to May 2021, 61 GD patients (13 males, 48 females; age (46.0±13.8) years) who received 131I treatment in Zhangzhou Affiliated Hospital of Fujian Medical University were enrolled. The outcomes of treatment were recovery, unhealed or hyperthyroidism recurrence (event 1), and hypothyroidism (event 2). Follow-up was started 1 month after 131I treatment and ended 1 year later. It was terminated in the following conditions: one of the two events occurred; no event occurred after 1 year of follow-up; the research deadline was up. The Fine-Gray test was used to analyze the factors related to event 1, and then the competitive risk model was established. Results:Thirty-nine patients had hypothyroidism, 17 patients were unhealed or had hyperthyroidism recurrence, 2 patients lost follow-up, and 3 patients had normal thyroid function after 1 year follow-up. Multivariate analysis showed that effective half-life (hazard ratio ( HR)=1.74, 95% CI: 1.10-2.75, β=0.55, P=0.019) and thyroid volume ( HR=1.12, 95% CI: 1.07-1.17, β=1.12, P<0.001) were risk factors for event 1, while the elasticity of thyroid was a protective factor ( HR=0.17, 95% CI: 0.06-0.54, β=-1.76, P=0.003). The C index of the nomogram constructed based on the multi-factor competitive risk model was 0.784(95% CI: 0.633-0.935). Conclusions:Thyroid volume, elastic value, and effective half-life are associated with treatment outcomes of 131I. The competitive risk model can predict the therapeutic outcomes of GD patients treated with 131I.
