术后DTC患者^(131)I治疗后不良反应的研究进展

Research progress of postoperative adverse reactions in patients with DTC after ^(131)I treatment

分化型甲状腺癌(differentiated thyroid cancer,DTC)目前国际上推荐的治疗方案是手术切除、^(131)I治疗和甲状腺激素替代治疗的综合治疗。由于^(131)I治疗后部分非甲状腺组织(如唾液腺、泪腺等)因表达钠碘转运体也会摄取^(131)I,^(131)I发出的核射线对这些组织会有一定的损伤。由于DTC患者^(131)I治疗后生存期长,其可能产生的不良反应会影响患者的生存质量,逐渐引起学者担忧。^(131)I治疗常见的短期不良反应是唾液腺和泪腺功能障碍。已报道的长期不良反应是第二原发性恶性肿瘤(second primary malignancies,SPM),以及性腺功能异常和女性生殖功能异常。这些并发症会影响患者的生活质量,严重者甚至会危及生命。了解^(131)I治疗不良反应的发生率和可能的风险对于选择最佳DTC治疗策略至关重要。因此,本文系统地综述了^(131)I治疗对DTC患者的短期、长期不良反应。

The currently recommended treatment regimen of differentiated thyroid cancer is a comprehensive treatment of surgical resection, 131I therapy and thyroid hormone replacement therapy. However, since the following tissues express sodium iodide transporters, when 131I therapy also affects many non-thyroid tissues, including salivary glands, lacrimal glands and so on .Because the incidence of differentiated thyroid cancer is increasing, and the prognosis is good, so we may show more concerns about adverse reactions about 131I therapy. Common intermediate-term adverse effects of 131I are salivary and lacrimal gland dysfunction. Long term adverse effects that have been reported are second primary malignancies(SPM), as well as abnormalities in gonadal function and female reproductive outcomes. These complications mainly affect the patient’s quality of life but can even be life threatening. Insight into the prevalence and risk factors of adverse effects of 131I therapy is essential to develop optimal DTC treatments strategies. Therefore, we systematically examined the risk of intermediate and long-term adverse effects of 131I therapy in DTC patients .