{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T05:08:57Z","timestamp":1789016937735,"version":"build-2803163510"},"reference-count":55,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"\n Background<\/jats:title>\n \n Adolescents and young adults (AYAs) with differentiated thyroid cancer (DTC) undergoing radioiodine-131 (\n 131<\/jats:sup>\n I) therapy endure unique developmental and psychosocial challenges, yet evidence for adolescent-tailored supportive interventions remains scarce. This retrospective before-after cohort program is associated with improvements in psychological distress, treatment adherence, and social reintegration.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We enrolled 220 eligible patients aged 13\u201325 years with DTC receiving\n 131<\/jats:sup>\n I therapy (2016-2024). The control group (n=85) received routine care, while the observation group (n=135) received a multi-component supportive care program. It included narrative medicine interviews, radiation education, fertility and career counseling, social adaptation training, and sustained follow-up. Primary outcomes were anxiety (SAS) and depression (SDS) scores. Secondary outcomes covered adherence, social adaptation, fertility cognition and satisfaction. Linear mixed-effects models analyzed repeated SAS\/SDS data; propensity score inverse probability weighting(IPTW), multivariable regression and Benjamini\u2013Hochberg FDR correction were applied to adjust confounders and handle multiple comparisons.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n In linear mixed-effects models, the observation group exhibited significantly lower 6-month SAS and SDS scores (all adjusted P &lt; 0.001).Significant group\u00d7time interactions for both scales demonstrated sustained psychological improvements. In multivariable logistic regression analyses adjusting for potential confounders, the observation group also achieved superior treatment adherence(\n \n \n \n aOR<\/mml:mtext>\n =<\/mml:mo>\n 2.71<\/mml:mn>\n \u00a0<\/mml:mtext>\n ,<\/mml:mo>\n 95<\/mml:mn>\n %CI<\/mml:mtext>\n :<\/mml:mo>\n (<\/mml:mo>\n 1.52<\/mml:mn>\n \u2013<\/mml:mo>\n 4.83<\/mml:mn>\n )<\/mml:mo>\n <\/mml:mrow>\n <\/mml:math>\n <\/jats:inline-formula>\n , school\/work resumption rates\n \n \n \n (<\/mml:mo>\n aOR<\/mml:mtext>\n =<\/mml:mo>\n 2.35<\/mml:mn>\n ,<\/mml:mo>\n 95<\/mml:mn>\n %<\/mml:mo>\n CI<\/mml:mtext>\n :<\/mml:mo>\n 1.22<\/mml:mn>\n \u2212<\/mml:mo>\n 4.51<\/mml:mn>\n )<\/mml:mo>\n <\/mml:mrow>\n <\/mml:math>\n <\/jats:inline-formula>\n , and medical satisfaction\n \n \n \n (<\/mml:mo>\n aOR<\/mml:mtext>\n =<\/mml:mo>\n 2.01<\/mml:mn>\n ,<\/mml:mo>\n 95<\/mml:mn>\n %<\/mml:mo>\n CI<\/mml:mtext>\n :<\/mml:mo>\n 1.11<\/mml:mn>\n \u2212<\/mml:mo>\n 3.64<\/mml:mn>\n )<\/mml:mo>\n <\/mml:mrow>\n <\/mml:math>\n <\/jats:inline-formula>\n \n \n \n (<\/mml:mo>\n allFDR<\/mml:mtext>\n \u2212<\/mml:mo>\n P<\/mml:mtext>\n <<\/mml:mo>\n 0.05<\/mml:mn>\n )<\/mml:mo>\n <\/mml:mrow>\n <\/mml:math>\n <\/jats:inline-formula>\n .IPTW sensitivity analyses corroborated these findings. Exploratory subgroup analyses did not reveal consistent evidence of differential intervention effects across most subgroups.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n A standardized adolescent-centered supportive care program was associated with persistent anxiety and depression relief, improved adherence and social reintegration among AYAs with DTC receiving\n 131<\/jats:sup>\n I therapy. While these real-world findings support program feasibility, prospective multicenter randomized trials are required to confirm causal efficacy.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fendo.2026.1901279","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T04:29:50Z","timestamp":1789014590000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Systematic adolescent-centered supportive care program is associated with improved psychological status, treatment adherence, and social adaptation in adolescents with thyroid cancer undergoing radioiodine-131 therapy: a retrospective before-after cohort study with historical controls"],"prefix":"10.3389","volume":"17","author":[{"given":"Guoxiu","family":"Lu","sequence":"first","affiliation":[{"name":"Department of Nuclear Medicine, General Hospital of Northern Theatre Command","place":["Shenyang, 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China"]},{"name":"Training Base for Graduate, General Hospital of Northern Theater Command, DaLian Medical University","place":["Shenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guoxu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, General Hospital of Northern Theatre Command","place":["Shenyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.medcli.2024.12.005","article-title":"Thyroid cancer","volume":"164","author":"Reverter","year":"2025","journal-title":"Med Clin (Barc)"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-025-17419-1","article-title":"Landmark studies in differentiated thyroid cancer","volume":"32","author":"Fisher","year":"2025","journal-title":"Ann Surg 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