不同放射剂量对甲状腺癌术后残余癌放疗的效果观察

Effect observation of different radiation doses on residual cancer radiotherapy after thyroid carcinoma

目的探讨不同放射剂量对甲状腺癌术后残余癌患者进行放疗后的临床疗效。方法选择2010年1月至2011年1月我院收治的84例甲状腺癌术后残余癌患者,根据放射剂量的不同将患者分为观察组和对照组,各42例。其中对照组放射剂量为45~49 Gy,而观察组患者使用50~75 Gy的放射剂量,比较两组患者不同放射剂量下放疗后1、3、5年的生存率,同时比较不同病理类型甲状腺癌患者放疗后1、3、5年的生存率。结果观察组患者在放疗后1、3、5年的生存率均明显高于对照组患者,差异有统计学意义(P<0.05)。乳头状癌、滤泡状腺癌以及髓样癌患者在放疗后1、3、5年的生存率比较,差异无统计学意义(P>0.05),但是均明显高于甲状腺未分化癌患者(P<0.05)。结论对于甲状腺癌术后残余癌患者,术后给予50~75 Gy的放射剂量进行放疗治疗,能够提高患者术后生存率,但甲状腺未分化癌患者放疗后的生存率相较于其他病理类型均更低。

Objective To discuss the clinical efficacy of different radiation dosages in the treatment of patients with residual cancer radiotherapy after thyroid carcinoma. Methods Eighty-four cases of patients with residual cancer after thyroid cancer operation admitted in our hospital from January 2010 to January 2011 were selected and divided into observation group and control group according to different radiation dosages, with 42 cases in each group. The radiation dosage was 45-49 Gy in the control group, and the patients in observation group adopted the radiation dosage of 50-75 Gy. The survival rates of the two groups after l, 3 and 5 years of different radiation dosages were compared. At the same time, the survival rates of thyroid cancer patients with different pathological patterns were compared after 1, 3 and 5 years of radiotherapy. Results The survival rates of patients in the observation group were obviously higher than those in the control group after 1, 3 and 5 years of radiotherapy, the differences were statistically significant （P〈0.05）. There were no significant differences in the survival rates of patients with papillary carcinoma, follicular carcinoma and medullary carcinoma after 1, 3 and 5 years of radiotherapy （P〉0.05）, but they were all significantly higher than those of undifferentiated thyroid cancer patients （P〈0.05）. Conclusion For patients with residual cancer after thyroid cancer operation, 50~75 Gy radiological dosage of radiotherapy can improve the postoperative survival rate, but the survival rate of patients with undifferentiated thyroid cancer is relatively lower than other pathological patterns.