甲状腺全切除术联合^(131)I治疗甲状腺癌的临床疗效

The clinical effect of total thyroidectomy combined with ^(131)I in the treatment of thyroid cancer

目的探讨甲状腺全切除术联合^(131)I治疗甲状腺癌的临床疗效。方法回顾性分析124例接受甲状腺全切除术的甲状腺癌患者的临床资料,依据治疗方案的不同将患者分为观察组和对照组,每组62例,其中观察组患者接受甲状腺全切除术联合^(131)I治疗,对照组患者仅接受甲状腺全切除术治疗。比较两组患者治疗前后的血管内皮生长因子(VEGF)水平、甲状腺球蛋白(TG)水平、近期疗效、无进展生存期、1年复发率及不良反应发生情况。结果治疗前两组患者的VEGF和TG水平比较,差异均无统计学意义(P﹥0.05);治疗后观察组患者的VEGF和TG水平均明显低于对照组,差异均有统计学意义(P﹤0.01)。治疗后,观察组患者的近期疗效优于对照组,无进展生存期长于对照组,1年复发率低于对照组,差异均有统计学意义(P﹤0.05);治疗过程中,观察组患者眼睛干涩、味觉异常的发生率均高于对照组(P﹤0.05),但经对症处理后均可以缓解。结论甲状腺癌患者行甲状腺全切除术联合^(131)I治疗可明显提高治疗效果,延长患者的无进展生存期,降低术后复发率,虽可引发眼睛干涩及味觉异常等不良反应,但经对症处理后均可以缓解。

Objective To explore the clinical effect of total thyroidectomy combined with^131I treatment for patients with thyroid cancer. Method Clinical data of 124 patients with thyroid cancer underwent total thyroidectomy were selected and divided into observation group（62 cases） and control group（62 cases） according to different treatment regimens. The patients in observation group received total thyroidectomy combined with ^131I for treatment, the patients of control group received only total thyroidectomy for treatment. The levels of vascular endothelial growth factor（VEGF） and thyroglobulin（TG）, short-term effect, progression-free survival, 1-year recurrence and adverse reactions were observed before and after treatment. Result There was no significant difference in the levels of VEGF and TG between the two groups before treatment（P0.05）. After treatment, the levels of VEGF and TG of the observation group were significantly lower than those of the control group（P0.01）. After treatment, the short-term effect of the observation group was significantly better than that of the control group, the progression-free survival of patients in the observation group was significantly higher than that in the control group, and the 1-year recurrence rate of the observation group was significantly lower than that of the control group, all the differences were statistically significant（P0.05）. During the treatment, the incidence rates of dry eye and taste abnormalities in the observation group were significantly higher than those in the control group（P0.05）, which could be relieved after symptomatic treatment. Conclusion The combination of total thyroidectomy and ^131I for patients with thyroid cancer can significantly improve the therapeutic effect, prolong the progressionfree survival and reduce the postoperative recurrence rate. Although the incidence rates of eye dryness, taste abnormalities and other adverse reactions were higher, the symptoms can be alleviated by symptomatic treatment.