儿童分化型甲状腺癌肺转移14例131I治疗分析

Analysis of 131I therapy of pulmonary metastasis in differentiated thyroid cancer in 14 children

目的探讨儿童分化型甲状腺癌(DTC)肺转移的临床特征及131 I治疗效果。方法回顾分析14例首次接受131 I治疗时年龄≤18岁的DTC肺转移患儿的临床资料。结果14例患儿中男5例、女9例,平均年龄(12.71±3.05)岁,均在甲状腺全切或次全切术后接受131 I治疗,平均接受131 I治疗4次,中位累积剂量为9.43(8.25~19.74)GBq。14例患儿治疗后完全消除4例(28.6%)、好转或稳定8例(57.1%)、无效或进展2例(14.3%),有效率为85.7%(12/14)。中位随访时间63.4(6~124)月,患儿生存率为100%,中位无进展生存期63.5个月,2年无进展生存率84.61%,5年无进展生存率80.0%。结论儿童DTC肺转移发生率较高,131 I治疗有效。

Objective To explore the clinical features of pulmonary metastasis of differentiated thyroid cancer(DTC)in children and the therapeutic effect of 131I.Methods The clinical data of pulmonary metastasis of DTC in 14 patients who were≤18 years old at the time of initial 131I treatment were retrospectively analyzed.Results In 14 children(5 males and 9 females)an average age was(12.71±3.05)years.All the children were received 131I treatment after total or subtotal thyroidectomy and 131I treatment was received 4 times averagely and a median cumulative dose was 9.43(8.25-19.74)GBq.After treatment,lesions were completely eliminated in 4 cases(28.6%),improved or stabilized in 8 cases(57.1%)and ineffective or progressive in 2 cases(14.3%).The effective rate was 85.7%(12/14).The median follow-up time was 63.4 months(6-124 months),with a survival rate of 100%.The median progression free survival time was 63.5 months.The 2-year progression free survival rate was 84.61%and the 5-year progression free survival rate was 80.0%.Conclusion The incidence of lung metastasis of DTC is high in children,and 131I treatment is effective.