^(131)I治疗分化型甲状腺癌肺转移的疗效及影响因素

Effect and influencing factors of ^(131)I treatment in lung metastases of differentiated thyroid carcinoma

131I治疗能部分或完全消除分化型甲状腺癌(DTC)肺转移病灶,131I已成为治疗DTC肺转移的一种有效手段。131I治疗DTC肺转移的疗效受年龄、性别、肿瘤病理学类型、有无颈部淋巴结转移、有无远处转移(除肺外)、有无胸片显示、肺转移灶的大小及转移灶摄取131I的能力等多种因素的影响,其中有无除肺之外的远处转移、转移灶大小及转移灶摄取131I的能力是影响DTC肺转移131I治疗效果的主要因素。131I治疗DTC肺转移不良反应小,基本不影响血常规、肺功能和唾液腺功能等,仅少数单次大剂量或累积剂量较大的131I治疗引起严重的不良反应,如骨髓抑制、肺纤维化或放射性肺炎、唾液腺功能损害等。通过对131I治疗DTC肺转移疗效、不良反应和影响因素的研究总结,对DTC肺转移131I治疗前评价其治疗效果和确定其治疗方案有较好的指导意义。

^131I treatment can partly or completely eliminate lung metastases of DTC. ^131I has been an effective measure of treating lung metastases of DTC. Many factors, such as age, sex, histology, other distant metastases except lung, chest X rays, the size and functional features of lung metastases and so on the influence on the effect of ^131I treatment in lung metastases of DTC. The main factors are other distant metastases except lung, the size and functional features of lung metastases. ^131I treatment in lung metastases of DTC has a few side effects. ^131I treatment rarely influences hemogram, lung function and salivary function, barely a few large single dose or large accumuated dose of ^131I treatment cause grave side effects, such as myelosuppression, pulmonary fibrosis or radiation pneumonitis, salivary functional damage and so on. The summary of effect, side effects and influencing factors of ^131I treatment in lung metastases of DTC plays an important role in evaluating effect and determinating the treatment plan before ^131I treatment.