^(131)I联合唑来膦酸治疗甲状腺癌骨转移回顾性队列研究

Retrospective Cohort Study on Therapeutic Effect of ^(131)I Combined with Zoledronic Acid on Thyroid Carcinoma with Bone Metastasis

目的分析131I联合唑来膦酸治疗甲状腺癌骨转移的临床疗效。方法采用回顾性队列研究,将2006-2011年在某医院住院治疗的150例患者分为治疗组和对照组,治疗组应用131I联合唑来膦酸治疗,对照组单纯给以131I治疗,两组对象均随访观察6个月。根据治疗后疼痛缓解和生活质量改善判断疗效。结果治疗组总有效率为91.25%(73/80),对照组总有效率为78.58%(55/70),两组治疗结果差异有统计学意义(P<0.05);治疗组生活质量改善总有效率为90%(72/80),对照组总有效率为77.14%(54/70),两组生活质量改善总有效率差异有统计学意义(P<0.05)。主要不良反应为白细胞和血小板Ⅰ~Ⅱ度下降,少数患者出现一过性骨痛加重,出现轻微恶心呕吐,两组主要不良反应的差异不明显。结论 131I联合唑来膦酸治疗甲状腺癌骨转移是一种综合有效的治疗方法,比单用131I治疗甲状腺癌骨转移的效果更好,能够更有效地改善患者的生存质量。

Objective To analyze the clinical efficacy of 131 I plus zoledronic acid therapy for thyroid carcinoma with bone metastases. Methods With retrospective cohort study, 150 thyroid cancer patients with bone metastasis hospitalized in a hospital from 2006 to 2011 were divided into treatment group and control group. Treatment group was given the therapy of 131 I plus zoledronic acid, while control group only received the therapy of 131 I. The patients of the two groups were followed up for six months. After the treatment, pain relief and the improvement of quality of life were compared between the two groups. Results The total effective rates of treatment group and control group were 91.25 % （73/80） and 78.58% （55/70）, respec- tively, and there were statistically significant differences in the therapeutic effect between the two groups （P 〈 0.05）. There were statistically significant differences in the total effective rate of improved quality of life between treatment group （90%, 72/ 80） and control group （77.14 %, 54/70）, （P 〈 0.05）. The major adverse reactions were neutropenia and thrombocytopenia I - II. A small number of patients presented with transient aggravation in bone pain, and a small number of patients presented with mild nausea and vomiting. No statistically significant difference was found in the major adver reactions between the two groups. Conclusions The therapy of 131 I plus zoledronic acid is a comprehensive and effective treatment method for thyroid cancer with bone metastases, its clinical efficacy is better than that of 131I therapy and it can be more effective in improving patient＇s quality of life.