Analysis of influencing factors and efficacy prediction of 131I in the treatment of Graves′ disease
10.3760/cma.j.cn321828-20240311-00093
- VernacularTitle:131I治疗格雷夫斯病疗效的影响因素分析及疗效预测
- Author:
Ziyu MA
1
;
Xue LI
;
Yan WANG
;
Nan LIU
;
Jian TAN
;
Qiang JIA
;
Zhaowei MENG
;
Wei ZHENG
Author Information
1. 天津医科大学总医院核医学科，天津 300052
- Publication Type:Journal Article
- Keywords:
Graves disease;
Radiotherapy;
Iodine radioisotopes;
Treatment outcome;
Forecasting
- From:
Chinese Journal of Nuclear Medicine and Molecular Imaging
2025;45(1):24-28
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the factors affecting the efficacy of 131I treatment for Graves′ disease (GD) and to construct a predictive model for the treatment outcomes of 131I therapy. Methods:Retrospective analysis of the treatment efficacy was performed on 2 190 patients (547 males, 1 643 females, age (42.9±12.4) years) with GD, who received initial 131I treatment in Tianjin Medical University General Hospital between October 2013 and May 2018. Univariate analysis ( χ2 test, et al) and logistic regression were performed to analyze the possible factors affecting the efficacy of 131I treatment. An efficacy prediction model for 131I treatment of GD was constructed, and decision curve analysis (DCA) was used to evaluate the clinical utility of the prediction model. Results:The overall effectiveness rate of 131I treatment for GD patients was 99.95%(2 189/2 190), with a total cure rate of 83.74%(1 834/2 190), among which 94.11%(1 726/1 834) were cured after a single treatment. Pre-treatment thyroid mass was identified as an independent risk factor affecting the efficacy of initial 131I treatment (odds ratio ( OR)=0.983(95% CI: 0.977-0.989), P<0.001). The clinical cure rate was higher in patients who received an adequate dose of 131I compared with that in patients who didn′t receive an adequate dose (79.97%(1 537/1 922) vs 70.52%(189/268); χ2=12.57, P<0.001), but it did not increase the incidence of hypothyroidism within one year. A predictive model was constructed, and it was found that thyroid mass and disease duration had a relatively high impact on the clinical cure rate. The concordance index (C-index) of the predictive model was 0.623(95% CI: 0.593-0.654). DCA indicated that the predictive model offered substantial net benefits across a wide range of probability thresholds. Conclusions:131I treatment is effective in most patients with GD. The predictive model for efficacy of initial 131I treatment developed in this study can assist in evaluating treatment outcomes and help clinicians select the most suitable 131I treatment dose, enhancing clinical decision-making.
