Objective:

To characterize longitudinal changes in symptom network structure during RAI therapy and identify core and bridge symptoms across treatment phases, emphasizing their clinical significance.

Key Findings:

• Significant differences in network structure across timepoints (T0-T1: M = 0.306, P = 0.001; T0-T2: M = 0.347, P = 0.001), indicating the evolving nature of symptom interactions.
• Psychological distress consistently exhibited the highest strength centrality across all timepoints, underscoring its persistent impact on patient well-being.
• Throat/mouth symptoms emerged as a critical bridge connecting physical and psychological symptom clusters post-RAI, suggesting potential intervention points.
• Predictability of treatment-related physical symptoms increased significantly from T0 to T1-T2, indicating improved understanding of symptom trajectories.

Interpretation:

RAI therapy leads to substantial network reorganization, highlighting the persistent centrality of psychological distress and the role of throat/mouth symptoms as bridges between symptom domains, which may inform targeted interventions.

Limitations:

• Study conducted at a single institution, which may limit generalizability to broader populations.
• Potential biases in self-reported symptom assessments could affect the reliability of findings.

Conclusion:

The treatment-to-surveillance transition represents a critical period for psychological intervention, with throat/mouth symptoms identified as potential targets for improving symptom management in DTC patients, emphasizing the need for integrated care approaches.