Emerging systemic antitarget treatment for differentiated thyroid carcinoma

Factors influencing postoperative anxiety and depression following Iodine-131 treatment in patients with differentiated thyroid cancer: A cross-sectional study

BACKGROUND

Differentiated thyroid cancer (DTC) often seriously impacts patients’ lives. Radionuclide Iodine-131 (¹³¹I) is widely used in treating patients with DTC. However, most patients know little about radionuclide therapy, and the treatment needs to be performed in a special isolation ward, which can cause anxiety and depression.

AIM

To explore anxiety and depression status and their influencing factors after ¹³¹I treatment in patients with DTC.

METHODS

A questionnaire survey was conducted among postoperative patients with DTC who received ¹³¹I treatment at our hospital from June 2020 to December 2022. General patient data were collected using a self-administered demographic characteristics questionnaire. The self-rating depression scale and self-rating anxiety scale were used to determine whether patients were worried about their symptoms and the degree of anxiety and depression. The patients were cate-gorized into anxiety, non-anxiety, depression, and non-depression groups. Single-variable and multiple-variable analyses were used to determine the risk factors for anxiety and depression in patients with thyroid cancer after surgery.

RESULTS

A total of 144 patients were included in this study. The baseline mean score of self-rating anxiety and depression scales were 50.06 ± 16.10 and 50.96 ± 16.55, respectively. Notably, 48.62% (70/144) had anxiety and 47.22% (68/144) of the patients had depression. Sex, age, education level, marital status, household income, underlying diseases, and medication compliance significantly differed among groups (P < 0.05). Furthermore, multivariate logistic regression analysis showed that education level, per capita monthly household income, and medication compliance level affected anxiety (P = 0.015, 0.001, and 0.001 respectively. Patient’s sex, marital status, and underlying diseases affected depression (P = 0.007, 0.001, and 0.009, respectively).

CONCLUSION

Nursing interventions aiming at reducing the risk of anxiety and depression should target unmarried female patients with low education level, low family income, underlying diseases, and poor adherence to medications.

Impact of Thyroid Cancer Treatment on Renal Function: A Relevant Issue to Be Addressed

Thyroid cancers require complex and heterogeneous therapies with different impacts on renal function. In our systematic literature review, we analyzed several aspects: renal function assessment, the impact of radiotherapy and thyroid surgery on kidney functioning, and mechanisms of nephrotoxicity of different chemotherapy, targeted and immunologic drugs. Our study revealed that the renal impact of thyroid cancer therapy can be a limiting factor in all radiotherapy, surgery, and pharmacological approaches. It is advisable to conduct a careful nephrological follow-up imposing the application of body surface based estimated Glomerular Filtration Rate (eGFR) formulas for the purpose of an early diagnosis and treatment of renal failure, guaranteeing the therapy continuation to thyroid cancer patients.

Potential use of multikinase inhibitors in immunosuppressed patients with malignancies including thyroid cancer

In this article, we focus on a variety of immunosuppression scenarios and whether multikinase inhibitors, as systemic therapy for advanced thyroid carcinoma (TC), could be useful for the treatment of immunocompromised patients with TC. Lenvatinib and sorafenib, among other MKIs, have become the standard of care for advanced TC based on their efficacy data and despite their adverse effects. Currently, published data on MKIs in immunosuppressed patients are scarce. Secondary malignancies can arise in immunosuppressed patients who have undergone solid organ transplantation, human immunodeficiency virus-infected patients, and hematopoietic stem cell transplant recipients. This review will explore different immunosuppression settings, the risk of secondary malignancies in immunosuppressed patients, and the special characteristics of this population. Some considerations regarding anticancer treatment in immunosuppressed patients with advanced malignancies are reviewed.

Use of multikinase inhibitors/lenvatinib in patients with synchronous/metachronous cancers coinciding with radioactive-resistant differentiated thyroid cancer

This review focuses on patients with differentiated thyroid carcinoma (DTC) associated with multiple primary malignant neoplasm (MPMN) treated by multikinase inhibitors (MKIs) as systemic treatment for advanced disease. Despite the increasing frequency of MPMNs (many at an advanced stage) and the usefulness of MKIs for multiple metastatic cancers, published data on the management of MPMN and MKI therapies in this scenario are scarce. There are infrequent descriptions of patients with advanced MPMN treated with MKIs, but only a few have described advanced DTC. The management of MPMNs, including DTC and its particular circumstances, is reviewed, focusing on the evidence for MKI therapies. Some considerations for MPMN patients with advanced DTC are discussed, with the intention of helping physicians make decisions in these challenging situations and improving treatment and patient outcomes.

Research on the Expression Level of Matrin-Type Zinc Finger Protein 4 Gene in T Cells of Thyroid Carcinoma Tissue

In order to analyze the expression level of zinc finger matrin-type protein 4 (ZMAT4) gene in T cells of thyroid carcinoma (TC) tissue and its clinical significance to prognosis of patients based on bioinformatics and reverse transcription polymerase chain reaction (RT-PCR), 389 TC patients with ZMAT4 gene and its corresponding survival and prognosis are searched by the Cancer Genome Atlas database. The expression of ZMAT4 gene is compared between normal thyroid tissue and TC tissue by RT-PCR. The relationship between ZMAT4 expression levels and clinicopathological parameters and baseline data is analyzed. The experimental results show that the low expression of ZMAT4 gene has an important relationship with the development of thyroid cancer, and real-time monitoring of ZMAT4 gene in TC patients can effectively evaluate the prognosis of patients.