^(131)I治疗分化型甲状腺癌伴转移术后的副作用分析

Adverse effects of ^(131)I in postoperative patients of differentiated thyroid carcinoma with metastasis

目的:探讨131I治疗分化型甲状腺癌(DTC)转移灶的早期副作用。方法:本文回顾性分析了采用5.55 GBq131I治疗的DTC术后伴淋巴结转移的患者41例(男性9例,女32例,年龄21~69岁)。观察131I治疗后7 d内的颈部反应症状、涎腺反应症状、消化道反应症状,治疗后1个月、3个月时的白细胞、中性粒细胞、淋巴细胞、血小板、ALT、AST数值变化。结果:治疗后7 d内的常见的副反应症状主要有颈部疼痛、头晕、恶心、呕吐;治疗后1个月白细胞、中性粒细胞、淋巴细胞、血小板分别下降5%、6%、30%、15%,但在正常参考值范围内;治疗后3个月白细胞、中性粒细胞、淋巴细胞、血小板计数有所恢复,治疗前与治疗后1个月、3个月淋巴细胞计数比较差异有统计学意义(P<0.05)。治疗后1个月与治疗前血小板计数比较差异有统计学意义(P<0.05)。结论:DTC术后行131I清除甲状腺癌转移灶治疗早期副作用少、且容易处理,是安全的。

Objective：To investigate the adverse effects of 131 I in postoperative patients of differentiated thyroid carcinoma （ DTC ） with metastasis. Methods：Forty-one DTC patients（9 males, 32 females;age range, 21-69 years）, treated with 131I in dose of 5.55GBq were included, and the clinical data were reviewed regarding the adverse events at the neck, to salivary gland reaction and gastrointestinal reaction in 7days of therapy, as well as count changes of white blood cell（WBC）, neutrophilic granulocyte（NEUT）, lymphocytes（LYMPH） and platelets（PLT）, and level of alanine transarninase （ ALT） and aspartate aminotransferase（ AST） one month and three months after therapy.Results：Major adverse effects in 7 days of therapy were associated with neck pain , dizziness, nausea and vomiting, and after one month of therapy, were associated with decreased WBC（5%）, NEUT（6%）, LYMPH （30）% and PLT（15%） count, which were within the normal range.The counts of WBC, NEUT, LYMPH and PLT were recovered to a certain degree after 3 months of therapy.The difference was significant pertaining to the LYMH and PLT count before treatment and after one month and 3 months of ther-apy（P〈0.05）.Conclusion： 131I can be safe in killing the metastatic cells, with less early adverse effects for patients with differentiated thyroid carcino-ma.