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Objective <p>This study aims to analyze the annual trends in postoperative <sup>131</sup>I treatment frequency among differentiated thyroid cancer (DTC) patients and systematically evaluate the changes in psychological status and quality of life across different treatment stages, thereby providing an evidence-based foundation for developing precise patient support strategies.</p> Methods <p>We conducted a retrospective analysis of 1651 patients with nondistant metastatic DTC treated between 2018 and 2023 to examine trends in <sup>131</sup>I therapy. In addition, an observational analysis of routinely collected questionnaire data from 2024 was performed, including a psychological stress scale, the Hospital Anxiety and Depression Scale (HADS), and the Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30), to assess patients’ psychological status and quality of life as part of standard clinical follow-up across different treatment stages.</p> Results <p>The adoption of single-dose <sup>131</sup>I therapy for nonmetastatic DTC rose markedly from 5.99% (2018) to 98.34% (2023) (<i>χ</i><sup>2</sup> = 87.407, <i>p</i> &lt; 0.05), surpassing 92% after 2020. This shift was accompanied by a 38.9% reduction in treatment-cycle psychological distress (<i>p</i> &lt; 0.001), though acceptance decreased by 6.6% at the 6–12-month assessment stage (<i>p</i> = 0.028). Willingness for multiple therapies declined 28.1% (<i>p</i> &lt; 0.05), with variations by sex, education, and physician. HADS scores improved at subsequent assessment stages, and baseline anxiety was significantly associated with increased psychological risk at later stages (<i>r</i> = 0.534). Quality of life initially declined but showed subsequent improvement across treatment stages (<i>p</i> &lt; 0.01).</p> Conclusion <p>Under the trend of single-session <sup>131</sup>I therapy, a phase-specific health education system for high-risk groups is suggested. It may help strengthen pre-treatment cognitive intervention and post-treatment psychological support and provide a theoretical reference for improving adherence and long-term quality of life.</p>

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Changes in the frequency of postoperative 131I therapy and longitudinal assessment of psychological status and quality of life in patients with differentiated thyroid cancer

  • 期刊论文

  • 发表日期：

    2026年3月6日

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  • Yibo Chen,
  • Xiaoya Guo,
  • Jieqiong Shao,
  • Lixiang Wu,
  • Meiling Kang,
  • Mofan Liu,
  • Yuehao Xia,
  • Zhifang Wu,
  • Sijin Li,
  • Keyi Lu

摘要

Objective

This study aims to analyze the annual trends in postoperative 131I treatment frequency among differentiated thyroid cancer (DTC) patients and systematically evaluate the changes in psychological status and quality of life across different treatment stages, thereby providing an evidence-based foundation for developing precise patient support strategies.

Methods

We conducted a retrospective analysis of 1651 patients with nondistant metastatic DTC treated between 2018 and 2023 to examine trends in 131I therapy. In addition, an observational analysis of routinely collected questionnaire data from 2024 was performed, including a psychological stress scale, the Hospital Anxiety and Depression Scale (HADS), and the Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30), to assess patients’ psychological status and quality of life as part of standard clinical follow-up across different treatment stages.

Results

The adoption of single-dose 131I therapy for nonmetastatic DTC rose markedly from 5.99% (2018) to 98.34% (2023) (χ2 = 87.407, p < 0.05), surpassing 92% after 2020. This shift was accompanied by a 38.9% reduction in treatment-cycle psychological distress (p < 0.001), though acceptance decreased by 6.6% at the 6–12-month assessment stage (p = 0.028). Willingness for multiple therapies declined 28.1% (p < 0.05), with variations by sex, education, and physician. HADS scores improved at subsequent assessment stages, and baseline anxiety was significantly associated with increased psychological risk at later stages (r = 0.534). Quality of life initially declined but showed subsequent improvement across treatment stages (p < 0.01).

Conclusion

Under the trend of single-session 131I therapy, a phase-specific health education system for high-risk groups is suggested. It may help strengthen pre-treatment cognitive intervention and post-treatment psychological support and provide a theoretical reference for improving adherence and long-term quality of life.