Follow-up and evaluation of menstrual rhythm and fertility after iodine-131 treatment for papillary thyroid carcinoma in women of childbearing age_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WANG Rui , ZHANG Lei , GOU Zhengjiang , WANG Yang , BAI Chao , LI Xinxi , TIAN Ye ,  LUO Jun

Department of Vascular and Thyroid Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, P. R. China;

Corresponding author：

LUO Jun, Email: xmuluo@163.com

Keywords：

papillary thyroid carcinoma; iodine-131 treatment; childbearing age women; pregnancy

DOI：

10.7507/1007-9424.201710073

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Objective To investigate influence of iodine-131 (¹³¹I) treatment following total thyroidectomy on menstrual rhythm and fertility of childbearing age patients with papillary thyroid carcinoma (PTC). Methods The clinical data of 342 childbearing age patients with PTC treated with total thyroidectomy from January 2007 to December 2016 in the First Affiliated Hospital of Xinjiang Medical University were retrospectively analyzed. The patients were designed to ¹³¹I treatment group (126 cases) and non-¹³¹I treatment group (216 cases) according to the postoperative treatment. The menstrual rhythm and pregnancy after operation were regularly followed-up on postoperative 1 month. The age, nationality, occupation, menstrual rhythm, and pregnancy were analyzed by two independent samples t or Chi-square or Fisher test. Results ① There were no significant differences in the age, nationality, and occupation between the ¹³¹I treatment group and the non-¹³¹I treatment group (P>0.05). ② Compared with the non-¹³¹I treatment group, the proportions of the irregular menstruation were significantly increased on the 1st month and 3rd month of follow-up (P<0.05) in the¹³¹I treatment group, which had no statistically significant differences on the 6th month and 12th month of follow-up in two groups (P>0.05). Further the analysis results of the age stratification showed that had no significant differences at different follow-up time in these two groups (P>0.05). ③ The success rate of pregnancy also had no significant differences in these two groups both in the general and the age stratification analysis results (P>0.05). Conclusions ¹³¹I treatment following total thyroidectomy can affect menstrual rhythm of women in childbearing age at the early stage (within 6 months), but there is no abnormal menstruation on 6 months later, which dosen’t effect on pregnancy in women of childbearing age, and it is recommended that pregnancy should be renewed in 1-year after ¹³¹I treatment.

Citation： WANG Rui, ZHANG Lei, GOU Zhengjiang, WANG Yang, BAI Chao, LI Xinxi, TIAN Ye, LUO Jun. Follow-up and evaluation of menstrual rhythm and fertility after iodine-131 treatment for papillary thyroid carcinoma in women of childbearing age. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2018, 25(4): 424-427. doi: 10.7507/1007-9424.201710073 Copy

1.	Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
2.	陈祯勇. 分化型甲状腺癌外科治疗的研究进展. 当代医学, 2013, 18(2): 12-13.
3.	杨雷, 王宁. 甲状腺癌流行病学研究进展. 中华预防医学杂志, 2014, 48(8): 744-748.
4.	Lu LY, Shan FL, Li WB, et al. Short-term side effects after radioiodine treatment in patients with differentiated thyroid cancer. BioMed Research International, 2016. Article ID 4376720.
5.	林岩松, 李娇. 2015 年美国甲状腺学会《成人甲状腺结节与分化型甲状腺癌诊治指南》解读: 分化型甲状腺癌 ¹³¹I 治疗新进展. 中国癌症杂志, 2016, 26(1): 1-12.
6.	武新宇, 高永举, 尤伟, 等. ¹³¹I 治疗甲状腺乳头状癌颈部淋巴结转移的疗效观察及影响因素分析. 中华核医学与分子影像杂志, 2015, 35(2): 112-115.
7.	Foley TP Jr, Límanová Z, Potluková E. Medical consequences of Chernobyl with focus on the endocrine system: Part 1. Cas Lek Cesk, 2015, 154(5): 227-231.
8.	Liakos P, Schoenecker PL, Lyons D, et al. Evaluation of the efficacy of pelvic shielding in preadolescent girls. J Pediatr Orthop, 2001, 21(4): 433-435.
9.	Albano D, Bertagna F, Panarotto MB, et al. Early and late adverse effects of radioiodine for pediatric differentiated thyroid cancer. Pediatr Blood Cancer, 2017, 64(11). doi: 10.1002/pbc.26595.
10.	黄蕤, 李林. 分化型甲状腺癌的放射性碘-131 治疗. 中国普外基础与临床杂志, 2012, 19(8): 814-817.
11.	Ain KB, Gopalakrishnan V. Iodine uptake restoration in thyroid cancer. Internal Medicine Faculty Patents. 7. https://uknowledge.uky.edu/internalmedicine_patents/7.
12.	易艳玲, 石洪成, 陈波, 等. 分化型甲状腺癌患者的 ¹³¹I 有效半衰期. 原子能科学技术, 2010, 44(S1): 612-615.
13.	Beslic N, Licina S, Sadija A, et al. Incidence of hypothyreoidism after radioactive iodine-I131 treatment in dependance of hyperthyreoidism etiology and therapy dose. Med Arch, 2017, 71(4): 270-273.
14.	寇莹, 刘建中, 郝新忠, 等. 甲状腺癌 ¹³¹I 治疗后全身扫描盆腔浓聚 ¹³¹I 的临床分析. 国际放射医学核医学杂志, 2014, 38(1): 15-18, 58.
15.	Shim HK, Kim MR. Erratum to: Incidental findings of intense radioiodine uptake in struma ovarii and bilateral non-lactating breast simultaneously on post-ablation SPECT/CT for papillary thyroid cancer. Nucl Med Mol Imaging, 2017, 51(2): 198.
16.	Wu JX, Young S, Ro K, et al. Reproductive outcomes and nononcologic complications after radioactive iodine ablation for well-differentiated thyroid cancer. Thyroid, 2015, 25(1): 133-138.
17.	Souza Rosário PW, Alvarenga Fagundes T, Villas-Boas Fagundes AS, et al. Ovarian function after radioiodine therapy in patients with thyroid cancer. Exp Clin Endocrinol Diabetes, 2005, 113(6): 331-333.
18.	Kaewput C, Pusuwan P. Severe hyponatremia: a comorbidity with I131 therapy in a patient with papillary thyroid cancer. J Med Assoc Thai, 2014, 97(8): 886-890.
19.	Haymart MR, Banerjee M, Stewart AK, et al. Use of radioactive iodine for thyroid cancer. JAMA, 2011, 306(7): 721-728.
20.	Sioka C, Kouraklis G, Zafirakis A, et al. Menstrual cycle disorders after therapy with iodine-131. Fertil Steril, 2006, 86(3): 625-628.
21.	Ko KY, Yen RF, Lin CL, et al. Pregnancy outcome after I-131 therapy for patients with thyroid cancer: a nationwide population-based cohort study. Medicine (Baltimore), 2016, 95(5): e2685.
22.	Garsi JP, Schlumberger M, Rubino C, et al. Therapeutic administration of ¹³¹I for differentiated thyroid cancer: radiation dose to ovaries and outcome of pregnancies. J Nucl Med, 2008, 49(5): 845-852.
23.	Dottorini ME, Lomuscio G, Mazzucchelli L, et al. Assessment of female fertility and carcinogenesis after iodine-131 therapy for differentiated thyroid carcinoma. J Nucl Med, 1995, 36(1): 21-27.
24.	Metallo M, Groza L, Brunaud L, et al. Long-term quality of life and pregnancy outcomes of differentiated thyroid cancer survivors treated by total thyroidectomy and I131 during adolescence and young adulthood. Int J Endocrinol, 2016. Article ID 7586482. http://dx.doi.org/10.1155/2016/7586482.

1. Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
2. 陈祯勇. 分化型甲状腺癌外科治疗的研究进展. 当代医学, 2013, 18(2): 12-13.
3. 杨雷, 王宁. 甲状腺癌流行病学研究进展. 中华预防医学杂志, 2014, 48(8): 744-748.
4. Lu LY, Shan FL, Li WB, et al. Short-term side effects after radioiodine treatment in patients with differentiated thyroid cancer. BioMed Research International, 2016. Article ID 4376720.
5. 林岩松, 李娇. 2015 年美国甲状腺学会《成人甲状腺结节与分化型甲状腺癌诊治指南》解读: 分化型甲状腺癌 ¹³¹I 治疗新进展. 中国癌症杂志, 2016, 26(1): 1-12.
6. 武新宇, 高永举, 尤伟, 等. ¹³¹I 治疗甲状腺乳头状癌颈部淋巴结转移的疗效观察及影响因素分析. 中华核医学与分子影像杂志, 2015, 35(2): 112-115.
7. Foley TP Jr, Límanová Z, Potluková E. Medical consequences of Chernobyl with focus on the endocrine system: Part 1. Cas Lek Cesk, 2015, 154(5): 227-231.
8. Liakos P, Schoenecker PL, Lyons D, et al. Evaluation of the efficacy of pelvic shielding in preadolescent girls. J Pediatr Orthop, 2001, 21(4): 433-435.
9. Albano D, Bertagna F, Panarotto MB, et al. Early and late adverse effects of radioiodine for pediatric differentiated thyroid cancer. Pediatr Blood Cancer, 2017, 64(11). doi: 10.1002/pbc.26595.
10. 黄蕤, 李林. 分化型甲状腺癌的放射性碘-131 治疗. 中国普外基础与临床杂志, 2012, 19(8): 814-817.
11. Ain KB, Gopalakrishnan V. Iodine uptake restoration in thyroid cancer. Internal Medicine Faculty Patents. 7. https://uknowledge.uky.edu/internalmedicine_patents/7.
12. 易艳玲, 石洪成, 陈波, 等. 分化型甲状腺癌患者的 ¹³¹I 有效半衰期. 原子能科学技术, 2010, 44(S1): 612-615.
13. Beslic N, Licina S, Sadija A, et al. Incidence of hypothyreoidism after radioactive iodine-I131 treatment in dependance of hyperthyreoidism etiology and therapy dose. Med Arch, 2017, 71(4): 270-273.
14. 寇莹, 刘建中, 郝新忠, 等. 甲状腺癌 ¹³¹I 治疗后全身扫描盆腔浓聚 ¹³¹I 的临床分析. 国际放射医学核医学杂志, 2014, 38(1): 15-18, 58.
15. Shim HK, Kim MR. Erratum to: Incidental findings of intense radioiodine uptake in struma ovarii and bilateral non-lactating breast simultaneously on post-ablation SPECT/CT for papillary thyroid cancer. Nucl Med Mol Imaging, 2017, 51(2): 198.
16. Wu JX, Young S, Ro K, et al. Reproductive outcomes and nononcologic complications after radioactive iodine ablation for well-differentiated thyroid cancer. Thyroid, 2015, 25(1): 133-138.
17. Souza Rosário PW, Alvarenga Fagundes T, Villas-Boas Fagundes AS, et al. Ovarian function after radioiodine therapy in patients with thyroid cancer. Exp Clin Endocrinol Diabetes, 2005, 113(6): 331-333.
18. Kaewput C, Pusuwan P. Severe hyponatremia: a comorbidity with I131 therapy in a patient with papillary thyroid cancer. J Med Assoc Thai, 2014, 97(8): 886-890.
19. Haymart MR, Banerjee M, Stewart AK, et al. Use of radioactive iodine for thyroid cancer. JAMA, 2011, 306(7): 721-728.
20. Sioka C, Kouraklis G, Zafirakis A, et al. Menstrual cycle disorders after therapy with iodine-131. Fertil Steril, 2006, 86(3): 625-628.
21. Ko KY, Yen RF, Lin CL, et al. Pregnancy outcome after I-131 therapy for patients with thyroid cancer: a nationwide population-based cohort study. Medicine (Baltimore), 2016, 95(5): e2685.
22. Garsi JP, Schlumberger M, Rubino C, et al. Therapeutic administration of ¹³¹I for differentiated thyroid cancer: radiation dose to ovaries and outcome of pregnancies. J Nucl Med, 2008, 49(5): 845-852.
23. Dottorini ME, Lomuscio G, Mazzucchelli L, et al. Assessment of female fertility and carcinogenesis after iodine-131 therapy for differentiated thyroid carcinoma. J Nucl Med, 1995, 36(1): 21-27.
24. Metallo M, Groza L, Brunaud L, et al. Long-term quality of life and pregnancy outcomes of differentiated thyroid cancer survivors treated by total thyroidectomy and I131 during adolescence and young adulthood. Int J Endocrinol, 2016. Article ID 7586482. http://dx.doi.org/10.1155/2016/7586482.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Follow-up and evaluation of menstrual rhythm and fertility after iodine-131 treatment for papillary thyroid carcinoma in women of childbearing age

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