分化型甲状腺癌术后~(131)I治疗的效果分析

目的:评价大剂量131I治疗分化型甲状腺癌(DTC)术后及合并甲状腺外转移患者的疗效。方法:本文回顾性分析了197例DTC术后患者,清除甲状腺组织(简称"清甲")治疗69例,转移灶治疗128例。给药剂量:①清甲治疗组:常规给予131I3.7GBq清甲并辅以甲状腺素抑制治疗;②转移灶治疗组:首次清甲治疗后6个月,治疗淋巴结转移灶患者平均给予131I4.44GBq,治疗远处转移灶患者平均给予131I6.48GBq;并都辅以甲状腺素抑制治疗。以Tg,TgAb,颈部超声,肺部X-线,131I全身显像结果综合判定疗效。结果:清甲治疗组完全清除64例,完全清除率为92.8%(64/69);转移癌治疗组的治愈率57.8%(74/128)。结论:DTC术后行131I治疗,并辅甲状腺素抑制治疗疗效显著;淋巴结转移者的疗效高于远处转移者。

Clinical assessment of 131I therapy in postoperative patients with differentiated thyroid carcinoma

Objective：To evaluate the therapeutic effect of ^131I in postoperative patients with the differentiated thyroid carcinoma（DTC） and distant metastasis. Methods：The clinical data were retrospectively analyzed in 197 eases with DTC confirmed postoperatively by pathology, of whom 69 cases received removal of the residual thyroid and 128 cases underwent treatment in distant metastasis. The patients in the group of removal of the residual thyroid were given radioiodine treatment at doses of 3.7GBq. Those with lymphatic or distant metastasis were treated by radioiodine at doses of 4.44GBq and 6.48GBq, respectively, after 6 months of the first removal of the residual thyroid. All patients received thyroxine suppression besides the treatment described above. The therapeutic effect was assessed comprehensively by detection of thyroglohulin（Tg） and thyroglobulin antibody（TgAb）, neck ultrasonography, chest X-ray and total body opacification by ^131I. Results： The residual thyroid tissues were removed in 64, which accounted for 92. 8% （ 64/69 ）. 57.8% （ 74/128 ） were cured in patients with metastasis. Conclusion： ^131I treatment together with thyroxine suppression is effective for postoperative DTC patients. The effect for cases with lymphatic metastasis is superior to those of distant metastasis.