不同临床分期乳头状甲状腺癌病人术后大剂量^(131)I治疗效果比较

POSTOPERATIVE LARGE DOSE ^(131)I THERAPY FOR PATIENTS WITH PAPILLARY THYROID CARCINOMA OF DIFFERENT CLINICAL STAGES:COMPARISON OF TREATMENT EFFECTIVENESS

目的比较不同临床分期乳头状甲状腺癌(PTC)病人术后大剂量^(131)I治疗的效果。方法对87例术后经大剂量^(131)I治疗PTC病人的临床资料进行回顾性分析。比较不同临床分期、手术方式和年龄病人^(131)I治疗效果。结果Ⅰ、Ⅲ、Ⅳ期病人^(131)I治疗有效率分别为89.13%、77.27%和36.84%,Ⅰ期与Ⅲ期比较差异无显著性(P>0.05);Ⅰ、Ⅲ期分别与Ⅳ期比较差异有显著性(χ2=19.03、6.87,P<0.01)。行甲状腺全切病人^(131)I治疗有效率为91.67%,行次全切病人有效率为53.85%,两者比较差异有显著性(χ2=16.29,P<0.01)。<45岁和≥45岁病人^(131)I治疗有效率分别为86.84%和65.31%,两者比较差异有显著性(χ2=5.25,P<0.05)。结论Ⅰ期和Ⅲ期PTC病人术后^(131)I治疗效果基本相同,Ⅳ期病人疗效明显下降,疗效可能与手术方式不同造成的残留甲状腺组织大小有关。

Objective To compare the efficacy of postoperative large-dose 131I therapy for patients with different-stage papillary thyroid carcinoma （PTC）. Methods Clinical data of 87 PTC patients received postoperative large-dose 131I therapy were retrospectively reviewed. The efficacy in patients of different clinical stages, operative method and patient age was compared. Results The effective power of 131I therapy for stages Ⅰ , Ⅲ and Ⅳ PTC were 89.13X, 77.27% and 36.84%, respectively. The difference in efficacy between stage Ⅰ and stage Ⅲ was not significant, while the differences in that between stage Ⅰand stage Ⅳ, stage Ⅱand stage Ⅳ were significant （x2 = 19.03,6.87 ;P〈0.01）. The effective power of 131I therapy in patients underwent total t hyroidectomy was 91.67%, and that in patients underwent partial thyroidectomy was 53.85 %, the difference being significant （;g 2 = 16.29, P % 0.01）. The effective power in patients younger than 45 years of age and those of 45 or older than 45 was 86.84 and 65.31%, respectively, the difference being significant （x2=5.25,P%0.05）. Conclusion The efficacy of postoperative 131I therapy for stage Ⅳ and stage Ⅲ patients was basically same, the efficacy markedly decreased in stage Ⅳ. The curative effect might be associated with the size of residual thyroid tissue because of different operation methods.