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The Effects of Radioiodine Treatment on Health-Related Quality of Life in Patients Treated for a Differentiated Thyroid Carcinoma: A Systematic Review and Meta-Analysis

In brief

Thyroid cancer patients' quality of life usually approaches population levels after a year

Across 53 studies, quality of life was already lower than in the general population before radioiodine treatment; symptoms or anxiety sometimes worsened it around treatment, but it generally improved over the following months. After more than a year, it approached population levels, though not consistently, and some patients had lasting symptoms. Study differences limit conclusions about radioiodine's specific effects.

Journal
Thyroid : official journal of the American Thyroid Association (Q1)
Published
3 November 2026
Study design
Systematic review / meta-analysis of RCTs
Evidence level
Level 1, High (CEBM 1a)
Authors
Soline Bondet de La Bernardie, Charlotte Lussey-Lepoutre, Camille Buffet, Marie-Odile Bernier, Susanne Singer, Clémence Baudin
PMID
42975204
DOI
10.1177/10507256261499230

Why clinicians should know about it

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Abstract

BACKGROUND: The incidence of differentiated thyroid carcinoma (DTC) has markedly increased since the 1990s. The patients' health-related quality of life (HRQoL) is an essential outcome to consider, both short- and long-term. After thyroidectomy, treatment generally includes radioiodine therapy (RIT), the impact of which on HRQoL remains debated, particularly in patients at low risk of recurrence. This systematic review with meta-analysis aims to comprehensively evaluate the association of RIT with HRQoL in patients with DTC throughout the disease trajectory. METHODS: A systematic literature review was conducted, and the findings are reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Scopus, Web of Science, and Cochrane databases were searched for studies published between January 2000 and June 2026. Observational studies and randomized controlled trials assessing HRQoL in patients with DTC treated with RIT were eligible for inclusion. Methodological quality and risk of bias were assessed using the Newcastle-Ottawa Scale for observational studies and the Cochrane Risk of Bias 2 tool for randomized trials. Random-effects meta-analyses were performed when the data allowed. RESULTS: In total, 53 studies were included in the systematic review, of which 6 were included in the meta-analyses. Before the administration of RIT, patients' HRQoL was already impaired compared with that of the general population. After RIT, the onset of certain symptoms had sometimes a negative impact on HRQoL. Few months post treatment, an overall improvement in HRQoL was observed in most patients compared with baseline. More than one year post treatment, HRQoL approach is that of the general population. CONCLUSIONS: Symptoms or anxiety associated with RIT may impair HRQoL around the time of treatment. HRQoL tends to approach that of the general population, although it does not consistently reach the same level. Furthermore, some patients may continue to experience persistent symptoms whose severity depends on the dose received. The heterogeneity of the results highlights the importance of future studies using more homogeneous and thyroid-specific questionnaires, and to include analyses adjusted for confounding factors such as administered activity and preparation methods, along with a pre-surgical assessment, in order to better evaluate the specific effect of RIT on HRQoL.

Abstract as published, via PubMed.

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For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.