^(131)I治疗分化型甲状腺癌骨转移结果

Treatment results of radioactive iodine for bone metastasis from differentiated thyroid cancer

目的 分析131I治疗分化型甲状腺癌骨转移的结果。方法 回顾性分析 32例接受131I治疗的分化型甲状腺癌骨转移患者 ,其中 14例骨转移灶在131I治疗前接受手术治疗。结果 全组 5年和 10年总生存率分别为 91%和 79% ,骨转移后 5年和 10年生存率分别为 71%和 5 3 %。 2 4例骨转移伴有疼痛 ,131I治疗止痛有效率 (完全缓解和部分缓解 )为 88% ,其中完全缓解率为 5 0 % ,部分缓解率为 38%。 18例接受单纯131I治疗者 ,无 1例骨病灶完全消除 ,而手术加131I治疗的 14例中 ,9例骨病灶完全消除者均为单发骨转移灶。结论 131I是治疗分化型甲状腺癌骨转移的有效治疗手段 ,能缓解骨疼痛 ,并对部分骨转移灶有消除作用。手术合并131I治疗分化型甲状腺癌局限的骨转移灶可以有效地消除病灶 。

Objective To evaluate the results of 131 I treatment in differentiated thyroid cancer patients with bone metastasis. Methods Thirty two differentiated thyroid cancer patients with bone metastasis were reviewed retrospectively. All patients were treated with 131 I and 14 received operation prior to 131 I treatment. Results The overall 5 and 10 year survivals for all patients were 91% and 79%. The post bone metastasis survivals at 5 and 10 years were 71% and 53%, respectively. Except 8 patients, 24 patients with bone metastasis had skeletal pain as well. Twenty one of 24 (88%) patients were responsive after 131 I treatment with or without surgery, with a complete response of 50% and a partial response of 38%. According to bone metastases evidenced by X ray examination and ECT, none of the 18 patients who received 131 I therapy alone gave a complete remission, whereas 9 of 14 (64%) patients who received surgery and 131 I therapy did so. However, 12 of these 14 patients had had an isolated bone metastasis.Conclusions 131 I is an effective treatment for patients with painful multiple bone metastases. 131 I treatment can offer good pain relief. Surgery,in the form of local tumorectomy, combined with 131 I therapy is able to eliminate bone metastatic lesion altogether for solitary bone metastasis. We suggest that surgery combined with 131 I therapy for patients solitary bone metastasis be preferred.