Abstract
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Objectives Using meta-analysis method to evaluate the curative effect of different doses of 131I for removing post-thyroidectomy ablation of remnants in patients with DTC.
Methods By searching the Cochrane Library, MEDLINE, OVID, EMBASE, EBSCO and SpringerLink databases, the randomized controlled trials (RCT) literatures were screened on the curative effect of high-dose (3700MBq) and low-dose (1110MBq) 131I for removing postoperative residual thyroid tissue in patients with DTC from 1980 to August in 2013. A modified Jadad scale was used for quality evaluation of selected literatures. RveMan 5.0 software was used for statistical analysis.
Results 12 RCT research literatures involving 2290 patients were included in accordance with the inclusion and exclusion criteria. According to the successful criteria of thyroid remnant ablation reported in all literatures, there was no statistically difference in success rate of thyroid remnant ablation between low-dose group and high-dose group (RR=0.91, 95%CI [0.82~1.01], P=0.07). If 131I whole body scan negative was taken as successful criteria of thyroid remnant ablation therapy, there was statistically significant difference in success rate between both groups, (RR=0.94, 95%CI[0.88~0.99] , P=0.03). If two methods including rhTSH (371cases vs 305 cases) and steroid withdrawal (351 cases vs 299 cases ) were respectively used for 131I preparing therapy in both groups, there was no statistically significant difference in success rate of first thyroidectomy ablation, (RR=0.93, 95%CI [0.82~1.07], P=0.33 and RR=0.99, 95%CI [0.96-1.03], P=0.74). The incidence of severe adverse events in high-dose 131I group was much higher than that in low-dose group (RR=0.52, 95%CI [0.30 ~ 0.91], P =0.02).
Conclusions Two different doses of 131I treatment and two different preparation methods have similar efficacy in ablation of residual thyroid tissue in patients with DTC, but the incidence of adverse effects in low-dose 131I group is less.