放射性碘（RAI）治疗对不同类型的分化型甲状腺癌（DTC）的管理指导在临床实践中是相同的。然而，在不同类型的DTC中，RAI亲和力和治疗反应存在差异，因此RAI治疗的效果不能等同。我们从SEER数据库提取了DTC患者的数据进行回顾性分析。通过卡方检验比较病例组和对照组之间的差异。我们使用Kaplan-Meier统计和Cox回归分析来研究癌症特异性生存（CSS）。进行倾向性评分匹配，实现1：1的病例对照匹配。SEER数据库中共确定了105195例接受全甲状腺切除术的患者。与乳头状甲状腺癌（PTC）相比，滤泡性甲状腺癌（FTC）（63.8％）和甲状腺滤泡细胞肿瘤（64.4％）RAI治疗的比例较高。在多变量Cox回归模型中，RAI治疗是PTC的独立预后因素，但对OCA和FTC无影响。在亚组分析中，当存在明显的甲状腺肿瘤外展、淋巴结转移或有远处转移（DM）时，RAI治疗可以改善PTC的预后。然而，仅有区域性损害的OCA和FTC患者只有在存在DM时才能从RAI治疗中受益。高危患者接受RAI治疗在PTC中显示出更好的预后，而在OCA和FTC中则没有这种效果。RAI治疗是DTC的有效治疗方法，应在PTC、OCA和FTC患者中个别考虑。我们的结果为DTC的治疗选择提供了进一步的指导。版权所有© 2023 Guo, Zhang, Hu, Zhang, Huang和Shen.

The management guidelines of radioactive Iodine (RAI) therapy for distinct types of differentiated thyroid carcinoma (DTC) were the same in clinical practice. However, in distinct types DTC, differences in RAI avidity and response existed and the effect of RAI therapy could not be equated.DTC patients' data in SEER database were extracted to perform retrospective analysis. The differences between case group and control group were compared by chi-square tests. We used Kaplan-Meier statistics and Cox regression analyses to investigate cancer-specific survival (CSS). Propensity score-matched was performed to make 1:1 case-control matching.105195 patients who receiving total thyroidectomy were identified in SEER database. Compared to papillary thyroid carcinoma (PTC) (52.3%), follicular thyroid carcinoma (FTC) (63.8%) and oncocytic carcinoma of thyroid (OCA) (64.4%) had higher rates of RAI therapy. In the multivariable Cox regression model, RAI therapy was independent prognosis factor in PTC but not in OCA and FTC. In subgroup analysis, RAI therapy could improve prognosis in PTC when gross extrathyroidal extension or lymph node metastases or early survival when distant metastases (DM) were presented. However, OCA and FTC patients with DM rather than regional lesions only could benefit from RAI therapy. High-risk patients receiving RAI therapy showed a better prognosis in PTC but not in OCA and FTC.RAI therapy was an effective treatment for DTC and should be considered individually in PTC, OCA and FTC patients. Our results provided further guideline for treatment selection in DTC.Copyright © 2023 Guo, Zhang, Hu, Zhang, Huang and Shen.