^(131)I治疗分化型甲状腺癌合并远处转移的疗效及影响因素

Therapeutic Effect and Influencing Factor in ^(131)I Treated Differentiated ThyroidCancer Patients with Remote Metastases

目的分析^(131)I治疗分化型甲状腺癌(DTC)合并远处转移患者的疗效和影响因素。方法152例DTC合并远端转移灶患者,经^(131)I清甲治疗后,133例患者接受了^(131)I阶段性长期治疗,平均剂量(172.3±22.4)mCi/次(1mCi=37MBq),^(131)I人均治疗(8.31±5.2)次,间隔(127±26)d,其余因转移灶不摄取^(131)I或其他并发症放弃^(131)I治疗。随访期1~10年。结果经^(131)I治疗后,37例(24.3%)治愈,82例病情好转或控制,总有效率为78.2%,其余无效或恶化。影响^(131)I疗效的主要因素包括转移灶的性质和部位、患者的年龄和^(131)I治疗的副反应。结论^(131)I是治疗DTC合并远处转移的有效手段,早期发现转移灶及控制^(131)I治疗的副反应是该治疗方法的关键。

Objective To investigate the therapeutic effect and analyze influencing factors in ^131I treated differentiated thyroid cancers （DTC） patients with remote metastases. Methods Of all 152 DTC patients after ^131I ablation therapy, 133 patients received long-term periodic ^131I treatment, with averaged doses of （ 172.3 ± 22.4） mCi per treatment 8.31±5.2 treatment per cases and averaged time intervals （ 127 ± 26） d （1 mCi = 37 MBq）. Others were excluded from further ^131I therapy due to absence of ^131I uptake by the metastases or complications. The follow-up time ranged from 1 to 10 years. Results After ^131I treatments, 37 patients （24.3%） was completely cured and 82 patients improved or controlled, the overall effective rate reached 78.2%. Major factors affecting the treatment outcomes consisted of the characteristics and locations of the metastases, patients＇ age and their adverse reactions due to ^131I therapy. Conclusion ^131I is an effective method for the treatment of DTC patients with remote metastases. The key issues rely on the early detection of metastases and good management of adverse reactions.