小剂量^(131)Ⅰ治疗32例分化型甲状腺癌转移灶的临床分析

Clinical result of treatment of metastatic foci from differentiated thyriod carcinoma with low doses of ^(131)Ⅰ

目的评价分化型甲状腺癌伴远处转移患者接受多次小剂量131Ⅰ治疗的临床效果及其不良反应。方法常规给予患者每次口服131Ⅰ30mCi,两次治疗间隔6个月。根据131Ⅰ全身显像、血甲状腺球蛋白(Tg)水平判断治疗效果;观察治疗后血常规及甲状旁腺素(PTH)的变化。结果32例甲状腺癌伴远处转移患者治愈21例(65.6%),有效10例(31.3%),无效1例(3.1%);131Ⅰ治疗后无1例出现血细胞减少,无PTH降低。结论采用131Ⅰ多次小剂量治疗甲状腺癌转移灶疗效好,不良反应小,还能缩短住院时间,减少患者的经济负担。

Objective To assess the treatment effect of metastatic foci from differentiated thyriod carcinoma with lower than the conventional 100~150mCidoses of 131Ⅰ.Methods Thirty-two patients with metastatic foci from differentiated thyriod carcinoma were treated with 131Ⅰ 30 mCi,Blood picture and PTH were monitored weekly for 4 times.Treament efficacy was assessed 6months later with 131Ⅰ scanning and blood thyroglobulin levels detemination.Repeated doses of 131Ⅰ were adminstered if further therapy was indicated.Results Treatment efficacy：65.6%（21patients）;improved：31.3%（10 patients）;failure：3.1%（1 patients）.No adverse side-effect was finded. Conclusion Treatment with low doses of 131Ⅰ is safe,and it can shorten length of stay,and decrease radiation effect,and cut down side effect and economy burden,as far as possible to achieve therapeutic efficacy.