Effectiveness of radioiodine therapy on preventing recurrence in differentiated thyroid carcinoma: a systematic review

Background The effectiveness of radioiodine therapy (RAI) in reducing recurrence and improving overall survival in differentiated thyroid carcinoma (DTC) remains debated. This systematic review evaluates the impact of RAI on DTC recurrence and survival. Methods A comprehensive search was conducted across PubMed, ScienceDirect, Web of Science, CINAHL, and Tripdatabase, including studies from inception to August 2024. Only studies published in English with full-text availability were included. Risk of bias was assessed using the Revised Risk of Bias Assessment Tool for Nonrandomized Studies of Interventions (RoBANS 2). Results Nine studies were included, involving 161,703 participants (36,658 men and 125,045 women). The studies were geographically diverse, with four from the American continent, three from Asia, and two from Europe. RAI doses ranged from 30 to 300 mCi, with 30 mCi and 100 mCi being the most common. Five studies found that RAI reduced recurrence, while two found no significant effect. The median time to recurrence ranged from 10 months to 15 years, with most studies indicating a 1–2-year median. Regarding overall survival, two studies reported improvement with successful RAI therapy, while two found no significant impact. Conclusion RAI therapy shows potential in reducing recurrence in DTC, particularly within the first 2-year post-treatment, but its effect on overall survival remains unclear. Further high-quality research is necessary to confirm these findings and guide clinical practice.